Effect of Parental Adverse Childhood Experiences and Resilience on a Child’s Healthcare Reutilization
| Autor: | Heidi J Sucharew, Colleen Mangeot, Julianne Haney, Andrew F Beck, Kelsey Childress, Anita N Shah, Jeffrey M Simmons, Samir S. Shah, Katherine A Auger |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Parents medicine.medical_specialty Leadership and Management media_common.quotation_subject Assessment and Diagnosis Odds 03 medical and health sciences 0302 clinical medicine Adverse Childhood Experiences 030225 pediatrics Intervention (counseling) Health care Hospital discharge Humans Medicine Family Prospective Studies 030212 general & internal medicine Child Prospective cohort study Care Planning Original Research media_common business.industry Health Policy General Medicine Hospital medicine Family medicine Fundamentals and skills Psychological resilience business Delivery of Health Care |
| Zdroj: | J Hosp Med |
| ISSN: | 1553-5606 1553-5592 |
| Popis: | BACKGROUND: Adverse childhood experiences (ACEs) are associated with poor health outcomes in adults. Resilience may mitigate this effect. There is limited evidence regarding how parents’ ACEs and resilience may be associated with their children’s health outcomes. OBJECTIVE: To determine the association of parental ACEs and resilience with their child’s risk of unanticipated healthcare reutilization. DESIGN, SETTING, AND PARTICIPANTS: We conducted a prospective cohort study (August 2015 to October 2016) at a tertiary, freestanding pediatric medical center in Cincinnati, Ohio. Eligible participants were English-speaking parents of children hospitalized on a Hospital Medicine or Complex Services team. A total of 1,320 parents of hospitalized children completed both the ACE questionnaire and the Brief Resilience Scale Survey. EXPOSURE: Number of ACEs and Brief Resilience Scale Score among parents. MAIN OUTCOMES: Unanticipated reutilization by children, defined as returning to the emergency room, urgent care, or being readmitted to the hospital within 30 days of hospital discharge. RESULTS: In adjusted analyses, children of parents with 4 or more ACEs had 1.69-times higher odds (95% Confidence Interval 1.11-2.60) of unanticipated reutilization after an index hospitalization, compared with children of parents with no ACEs. Resilience was not significantly associated with reutilization. CONCLUSION: Parental history of ACEs is strongly associated with higher odds of their child having unanticipated healthcare reutilization after a hospital discharge, highlighting an intergenerational effect. Screening may be an important tool for outcome prediction and intervention guidance following pediatric hospitalization. |
| Databáze: | OpenAIRE |
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