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Issues Identified by Postdischarge Contact after Pediatric Hospitalization: A Multisite Study
Author(s) -
Rehm Kris P.,
Brittan Mark S.,
Stephens John R.,
Mummidi Pradeep,
Steiner Michael J.,
Gay James C.,
Ayubi Soleh Al,
Gujral Nitin,
Mittal Vandna,
Dunn Kelly,
Chiang Vincent,
Hall Matt,
Blaine Kevin,
O'Neill Margaret,
McBride Sarah,
Rogers Jayne,
Berry Jay G.
Publication year - 2018
Publication title -
journal of hospital medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.128
H-Index - 65
eISSN - 1553-5606
pISSN - 1553-5592
DOI - 10.12788/jhm.2934
Subject(s) - medicine , interquartile range , medicaid , bronchiolitis , logistic regression , hospital discharge , pneumonia , medical prescription , pediatrics , retrospective cohort study , emergency medicine , health care , nursing , respiratory system , economics , economic growth
BACKGROUND Many hospitals are considering contacting hospitalized patients soon after discharge to help with issues that arise. OBJECTIVES To (1) describe the prevalence of contact‐identified postdischarge issues (PDI) and (2) assess characteristics of children with the highest likelihood of having a PDI. DESIGN, SETTING, AND 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 non‐Hispanic 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.