Issues Identified by Postdischarge Contact after Pediatric Hospitalization: A Multisite Study.

Autor: Rehm KP; Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, USA. kris.rehm@vanderbilt.edu.; Vanderbilt University School of Medicine, Nashville, Tennessee, USA., Brittan MS; Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, USA., Stephens JR; North Carolina Children's Hospital, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA., Mummidi P; Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, USA., Steiner MJ; North Carolina Children's Hospital, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA., Gay JC; Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee, USA.; Vanderbilt University School of Medicine, Nashville, Tennessee, USA., Ayubi SA; Boston Children's Hospital, Boston, Massachusetts, USA., Gujral N; Boston Children's Hospital, Boston, Massachusetts, USA., Mittal V; Boston Children's Hospital, Boston, Massachusetts, USA., Dunn K; Boston Children's Hospital, Boston, Massachusetts, USA., Chiang V; Boston Children's Hospital, Boston, Massachusetts, USA.; Harvard Medical School, Boston, Massachusetts, USA., Hall M; Children's Hospital Association, Overland Park, Kansas, USA., Blaine K; Boston Children's Hospital, Boston, Massachusetts, USA., O'Neill M; Boston Children's Hospital, Boston, Massachusetts, USA., McBride S; Boston Children's Hospital, Boston, Massachusetts, USA.; Harvard Medical School, Boston, Massachusetts, USA., Rogers J; Boston Children's Hospital, Boston, Massachusetts, USA., Berry JG; Boston Children's Hospital, Boston, Massachusetts, USA.; Harvard Medical School, Boston, Massachusetts, USA.
Jazyk: angličtina
Zdroj: Journal of hospital medicine [J Hosp Med] 2018 Apr; Vol. 13 (4), pp. 236-242. Date of Electronic Publication: 2018 Feb 02.
DOI: 10.12788/jhm.2934
Abstrakt: 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.
(© 2018 Society of Hospital Medicine)
Databáze: MEDLINE
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