Document is current

Article History

Received: 20 May 2026

Revised: 23 July 2026

Accepted: 29 July 2026

First Online: 26 August 2026

Ethics

Competing interests: Charles Reuven Starobin Hatfield reports financial support from the Helmholtz Association through the Helmholtz Information & Data Science Academy, as well as from HeiGIT gGmbH. Kathrin E. Zangerl reports financial support from the Ministry of Science, Research and the Arts of the State of Baden-Württemberg. Till Bärnighausen serves as an editor for PLOS Medicine. All other authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Ethical approval and consent to participate: The analysis utilized anonymized data on pediatric ED visits. All data were obtained from AOK and contained no personal identifiers. As no individual-level or identifiable patient data were used, no additional ethics approval was required in accordance with institutional ethical guidelines. Data handling and storage followed established data protection and privacy standards of the Heidelberg Institute of Global Health and University Hospital Heidelberg, ensuring compliance with GDPR and relevant institutional policies.