Format

Send to

Choose Destination
J Hosp Med. 2018 Apr;13(4):236-242. doi: 10.12788/jhm.2934. Epub 2018 Feb 2.

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

Author information

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.

PMID:
29394301
DOI:
10.12788/jhm.2934

Supplemental Content

Full text links

Icon for Frontline Medical Communications Inc
Loading ...
Support Center