Kris P Rehm1,2, Mark S Brittan3, John R Stephens4, Pradeep Mummidi5, Michael J Steiner4, James C Gay5,2, Soleh Al Ayubi6, Nitin Gujral6, Vandna Mittal6, Kelly Dunn6, Vincent Chiang6,7, Matt Hall8, Kevin Blaine6, Margaret O'Neill6, Sarah McBride6,7, Jayne Rogers6, Jay G Berry6,7. 1. Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, USA. kris.rehm@vanderbilt.edu. 2. Vanderbilt University School of Medicine, Nashville, Tennessee, USA. 3. Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA. 4. North Carolina Children's Hospital, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA. 5. Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, USA. 6. Boston Children's Hospital, Boston, Massachusetts, USA. 7. Harvard Medical School, Boston, Massachusetts, USA. 8. Children's Hospital Association, Overland Park, Kansas, USA.
Abstract
BACKGROUND: Many hospitals are considering contacting hospitalized patients soon after discharge to help with issues that arise. OBJECTIVE: To (1) describe the prevalence of contactidentified postdischarge issues (PDI) and (2) assess characteristics of children with the highest likelihood of having a PDI. DESIGN, SETTING, PATIENTS: A retrospective analysis of hospital-initiated follow-up contact for 12,986 children discharged from January 2012 to July 2015 from 4 US children's hospitals. Contact was made within 14 days of discharge by hospital staff via telephone call, text message, or e-mail. Standardized questions were asked about issues with medications, appointments, and other PDIs. For each hospital, patient characteristics were compared with the likelihood of PDI by using logistic regression. RESULTS: Median (interquartile range) age of children at admission was 4.0 years (0-11); 59.9% were nonHispanic white, and 51.0% used Medicaid. The most common reasons for admission were bronchiolitis (6.3%), pneumonia (6.2%), asthma (5.1%), and seizure (4.9%). Twenty-five percent of hospitalized children (n=3263) reported a PDI at contact (hospital range: 16.0%-62.8%). Most (76.3%) PDIs were related to follow-up appointments (eg, difficulty getting one); 20.8% of PDIs were related to medications (eg, problems filling a prescription). Patient characteristics associated with the likelihood of PDI varied across hospitals. Older age (age 10-18 years vs <1 year) was significantly (P<.001) associated with an increased likelihood of PDI in 3 of 4 hospitals. CONCLUSIONS: PDIs were identified often through hospital-initiated follow-up contact. Most PDIs were related to appointments. Hospitals caring for children may find this information useful as they strive to optimize their processes for follow-up contact after discharge.
BACKGROUND: Many hospitals are considering contacting hospitalized patients soon after discharge to help with issues that arise. OBJECTIVE: To (1) describe the prevalence of contactidentified postdischarge issues (PDI) and (2) assess characteristics of children with the highest likelihood of having a PDI. DESIGN, SETTING, PATIENTS: A retrospective analysis of hospital-initiated follow-up contact for 12,986 children discharged from January 2012 to July 2015 from 4 US children's hospitals. Contact was made within 14 days of discharge by hospital staff via telephone call, text message, or e-mail. Standardized questions were asked about issues with medications, appointments, and other PDIs. For each hospital, patient characteristics were compared with the likelihood of PDI by using logistic regression. RESULTS: Median (interquartile range) age of children at admission was 4.0 years (0-11); 59.9% were nonHispanic white, and 51.0% used Medicaid. The most common reasons for admission were bronchiolitis (6.3%), pneumonia (6.2%), asthma (5.1%), and seizure (4.9%). Twenty-five percent of hospitalized children (n=3263) reported a PDI at contact (hospital range: 16.0%-62.8%). Most (76.3%) PDIs were related to follow-up appointments (eg, difficulty getting one); 20.8% of PDIs were related to medications (eg, problems filling a prescription). Patient characteristics associated with the likelihood of PDI varied across hospitals. Older age (age 10-18 years vs <1 year) was significantly (P<.001) associated with an increased likelihood of PDI in 3 of 4 hospitals. CONCLUSIONS: PDIs were identified often through hospital-initiated follow-up contact. Most PDIs were related to appointments. Hospitals caring for children may find this information useful as they strive to optimize their processes for follow-up contact after discharge.
Authors: Arti D Desai; Tamara D Simon; JoAnna K Leyenaar; Maria T Britto; Rita Mangione-Smith Journal: Acad Pediatr Date: 2018-08-02 Impact factor: 3.107
Authors: Kathleen Huth; Laura Amar-Dolan; Jennifer M Perez; Donna Luff; Amy P Cohen; Laurie Glader; Alan Leichtner; Lori R Newman Journal: Acad Pediatr Date: 2020-05-11 Impact factor: 3.107