Insurance status may be associated with differences in emergency department disposition among children presenting with supraventricular tachycardia (SVT), according to a retrospective cohort study published in the American Heart Journal.

The analysis evaluated pediatric emergency department (ED) encounters for SVT using data from the 2006-2018 US Nationwide Emergency Department Sample (NEDS). Patients aged 0–18 years with a primary diagnosis of SVT were included, while those with congenital heart disease were excluded. The primary exposure was insurance payor (public vs private), and the primary outcome was hospital admission or transfer. Secondary outcomes included inpatient length of stay (LOS), procedures, and mortality. Multivariable logistic regression models adjusted for age, hospital teaching status, hospital region, patient residence, and income.

A total of 38,896 ED encounters were analyzed. Median age was 11.5 years (IQR 6-15), 48% were male, 53% had private insurance, and 38% had public insurance. Admission or transfer occurred more frequently among publicly insured encounters compared with privately insured encounters (24% vs 18%; P < .0001). No significant differences were observed in LOS or procedural rates by payor.

In adjusted analyses, public insurance was associated with higher odds of admission or transfer (OR 1.6; 95% CI 1.2-2.2). Compared with infants aged <1 year, all older age groups were less likely to undergo admission or transfer.

These findings indicate that publicly insured encounters were more likely to result in hospital admission or transfer in this national sample.