Social Risk Factors Impact Hospital Readmission and Outpatient Appointment Adherence for Children with Congenital Heart Disease

Demianczyk, Abigail C; Behere, Shashank; Thacker, Deepika; Noeder, Maia M.; Delaplane, Emily; Pizarro, Christian; Sood, Erica

doi:10.1016/j.jpeds.2018.09.038

Cited by 28 publications

(19 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our study is among the surveys with the largest sample sizes in clinical BD research. Although most of our findings can be supported by previous studies, these well-known studies in BDs include no more than 1000 cases, even in developing countries [ 10 , 11 ]. For example, Down syndrome is the most common BD group and a significant contributor to neonatal and infant death.…”

Section: Discussionsupporting

confidence: 83%

Epidemiology of Birth Defects in Eastern China and the Associated Risk Factors

Wang

et al. 2021

Med Sci Monit

View full text Add to dashboard Cite

Background This study aimed to survey the overall situation of birth defects (BDs) among citizens of Hangzhou, China, and the risk factors of different BD types. Material/Methods We collected the data of 4349 perinatal infants with BDs in Hangzhou. The potentially associated risk factors of BDs were recorded and logistic regression analysis was used to predict the high incidence of BDs. Results Among all perinatal infants with BDs, there were 4105 (94.3%) single births, 225 (5.2%) twin births, and 10 (0.2%) multiple births. In clinical outcomes, there were 2477 (57.0%) live births, 1806 (41.5%) dead fetuses, and 11 (0.3%) stillbirths. Down syndrome ranked first, accounting for 30.7% of the total births, followed by cleft lip and polydactyly. Low family income, nulliparity, high parity, high education level, and taking contraceptives in early pregnancy were found to be risk factors of Down syndrome. Low parity, low education level, and pesticide exposure were found to be risk factors of cleft lip. For polydactyly, young age of the mother and a parity above 0 were identified as risk factors. Conclusions Different risks factors can influence BD development and potentially help to predict specific BD types, such as demographic features and harmful exposure in early pregnancy.

show abstract

Section: Discussionsupporting

confidence: 83%

Epidemiology of Birth Defects in Eastern China and the Associated Risk Factors

Wang

et al. 2021

Med Sci Monit

View full text Add to dashboard Cite

show abstract

“…Greater representation of racial, ethnic and socioeconomic diversity is particularly important, given the influence of these factors on physical and mental health service use. 8,88…”

Section: Limitations Of Captured Studies and The Current Reviewmentioning

confidence: 99%

Mental health care for parents of babies with congenital heart disease during intensive care unit admission: Systematic review and statement of best practice

Kasparian

Kan

Sood

et al. 2019

Early Human Development

Self Cite

View full text Add to dashboard Cite

Introduction: Congenital heart disease (CHD) is one of the most common causes of infant admission to pediatric intensive care and is associated with profound psychological stress for mothers, fathers and their infants. Intensive care unit admission represents an opportunity to offer evidence-based strategies to prevent or minimize severe psychological distress and promote secure bonding and attachment, alongside high-quality infant medical care.Objectives: We aimed to identify, synthesize and critically appraise published evidence on the efficacy and cost-effectiveness of mental health interventions delivered in neonatal, pediatric or cardiac intensive care units for parents of infants with CHD. A secondary goal was to develop recommendations for advancing health policy, practice and research in the field. Methods:In accordance with a prospectively registered protocol (CRD42019114507), six electronic databases were systematically searched for studies reporting results of a controlled trial of a mental health intervention for parents of infants aged 0-12 months with a congenital anomaly requiring intensive care unit admission. To maximize generalizability of results, trials involving infants with any type of structural congenital anomaly requiring surgery were included. Outcomes included intervention type, process, efficacy, and cost-effectiveness.Results: Across all forms of congenital anomaly, only five trials met inclusion criteria (four in CHD, one in gastrointestinal malformation). All interventions engaged parents face-to-face, but each had a distinct therapeutic approach (parent-infant interaction and bonding, early pediatric palliative care, psychoeducation, parenting skills training, and family-centered nursing). Four of the five trials demonstrated efficacy in reducing maternal anxiety, although the quality of evidence was low. Positive results were also found for maternal coping, mother-infant attachment, parenting confidence and satisfaction with clinical care, as well as infant mental (but not psychomotor) development at 6 months. Mixed results were found for maternal depression and infant feeding. No evidence of efficacy was found for improving parent, infant or family quality of life, physical health or length of infant hospital stay, and there were no data on costeffectiveness. Conclusions:Stronger evidence for the efficacy of mental health interventions to buffer the effects of intensive care unit admission for parents of infants with CHD is urgently needed. Robust, high-quality

show abstract

“…[29][30][31][32][33] Specifically, this body of work has frequently examined area-level measures of social determinants of health (e.g., area deprivation index, census tract, ZIP code, and county-level factors), and the specific subset of studies that do examine the effect of social needs at the individual level often rely on data extracted from notes rather than from formal diagnostic codes. 29,[31][32][33][34][35][36][37][38][39][40][41] To more precisely estimate the effect of SDOH or HRSN, the statistical models used in this body of work often control for a common set of covariates including sex, race, age, marital status, comorbidities, social determinants of health or social risk, and hospital or site characteristics. 29,30,[34][35][36][37]42,43 The effect of SDOH or HRSN has varied, but studies have identified that 34% of patients with two HRSN and 24.5% of patients with housing instability have hospital readmission, and for those who live in areas of high deprivation, the odds ratio of readmission was 1.7.…”

Section: Introductionmentioning

confidence: 99%

Health-Related Social Needs and Increased Readmission Rates: Findings from the Nationwide Readmissions Database

2021

View full text Add to dashboard Cite

BACKGROUND: While health-related social needs (HRSN) are known to compromise health, work to date has not clearly demonstrated the relationship between clinically acknowledged social needs, via ICD-10 Z-codes, and readmission. OBJECTIVE: Assess the rate of 30-, 60-, and 90-day readmission by the level of ICD-10-identified social need. In addition, we examined the associations between demographics, social need, hospital characteristics, and comorbidities on 30-day readmission. DESIGN: Retrospective study using the 2017 Nationwide Readmission Database PARTICIPANTS: We identified 5 domains of HRSN from ICD-10 diagnosis codes including employment, family, housing, psychosocial, and socioeconomic status (SES) and identified how many and which an individual was coded with during the year. MAIN MEASURES: The proportion of patients with 30-, 60-, and 90-day readmission stratified by the number of HRSN domains with a multivariable logistic regression to examine the relationship between the number/type of and readmission adjusting for sex, age, payer, hospital characteristics, functional limitations, and comorbidities. KEY RESULTS: From 13,217,506 patients, only 2.4% had at least one HRSN diagnosis. Among patients without HRSN, 11.5% had a 30-day readmission, compared to 27.0% of those with 1 domain, increasing to 63.5% for patients with codes in 5 domains. Similar trends were observed for 60-and 90-day readmission; 78.7% of patients with documented HRSN in all 5 domains were hospitalized again within 90 days. The adjusted odds ratio for readmission for individuals with all 5 domains was 12.55 (95% CI: 9.04, 17.43). Housing and employment emerged as two of the most commonly documented HRSN, as well as having the largest adjusted odds ratio. CONCLUSIONS: There is a dose-response relationship between the number of HRSN diagnoses and hospital readmission. This work calls attention to the need to develop interventions to reduce readmissions for those at social risk and demonstrates the significance of ICD-10 Z-codes in health outcomes studies.

show abstract

Social Risk Factors Impact Hospital Readmission and Outpatient Appointment Adherence for Children with Congenital Heart Disease

Cited by 28 publications

References 38 publications

Epidemiology of Birth Defects in Eastern China and the Associated Risk Factors

Epidemiology of Birth Defects in Eastern China and the Associated Risk Factors

Mental health care for parents of babies with congenital heart disease during intensive care unit admission: Systematic review and statement of best practice

Health-Related Social Needs and Increased Readmission Rates: Findings from the Nationwide Readmissions Database

Contact Info

Product

Resources

About