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Effect of Parental Adverse Childhood Experiences and Resilience on a Child's Healthcare Reutilization
Author(s) -
Shah Anita N,
Auger Katherine A,
Sucharew Heidi J,
Mangeot Colleen,
Childress Kelsey,
Haney Julianne,
Shah Samir S,
Simmons Jeffrey M,
Beck Andrew F,
Group on behalf of the HospitaltoHomes Outcomes Trial Study
Publication year - 2020
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.3396
Subject(s) - medicine , odds , psychological resilience , odds ratio , health care , medical home , intervention (counseling) , adverse childhood experiences , family medicine , pediatrics , psychiatry , mental health , logistic regression , psychology , primary care , pathology , economics , psychotherapist , economic growth
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% CI, 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.