Use of Post‐Acute Facility Care in Children Hospitalized With Acute Respiratory Illness

Berry, Jay G.; Wilson, Karen M.; Dumas, Helene M.; Simpser, Edwin; O’Brien, Judith A.; Whitford, Kathleen; May, Rachna; Mittal, Vineeta; Murphy, Nancy; Steinhorn, David M.; Agrawal, Rishi; Rehm, Kris P.; Marks, Michelle; Traul, Christine; Dribbon, Michael; Haines, Christopher J.; Hall, Matt

doi:10.12788/jhm.2780

Cited by 5 publications

(6 citation statements)

References 21 publications

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“…Findings of increased readmission risk for those discharged home, when compared to post-acute care facilities, complements additional emerging evidence that these post-discharge health services, such as increased access to sub-acute and skilled nursing facilities, might help prevent subsequent acute-care hospitalizations in children with medical complexity, particularly in patients post-tracheotomy 10 . Previous studies have demonstrated that post-acute care use in pediatric patients is uncommon, even for CMC 21,28,29 . Additionally, Hispanic ethnicity has also been associated with decreased use of post-acute care facilities in pediatric patients 21,28,29 .…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have demonstrated that post-acute care use in pediatric patients is uncommon, even for CMC 21,28,29 . Additionally, Hispanic ethnicity has also been associated with decreased use of post-acute care facilities in pediatric patients 21,28,29 . Our results may support future research to examine the association between availability and use of post-acute care facilities to prevent future bRTI hospital readmissions in this patient population.…”

Section: Discussionmentioning

confidence: 99%

“…Given possible confounding based upon previous preliminary data and hypothesized relationships, all variables evaluated in the unadjusted model of hospital readmission for a tracheostomy-associated bRTI were included in the multivariable Cox proportion hazard model. In addition to the covariates entered, we also tested an interaction term between ventilator dependence and discharge disposition because previous studies have found that patients who were ventilator-dependent were more likely to be discharged to a post-acute care facility 21 , thus potentially decreasing readmission risk. We also tested for collinearity between the gastrostomy tube procedure codes (representing new procedures) and diagnostic codes (representing pre-existing gastrostomy).…”

Section: Methodsmentioning

confidence: 99%

See 2 more Smart Citations

Risk factors for hospitalizations due to bacterial respiratory tract infections after tracheotomy

Russell

Thurm

Hall

et al. 2018

Pediatric Pulmonology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Risk factors for hospitalizations due to bacterial respiratory tract infections after tracheotomy

Russell

Thurm

Hall

et al. 2018

Pediatric Pulmonology

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“…These children also have more visits to the Emergency Department than a well child [ 14 , 75 , 77 – 79 ]. This rate of attendance is often higher than the rates of attendance of elderly patients over 85 years of age [ 75 ]. Higher rates of visits are associated with greater distance from the hospital and being a younger child and having a large number of medications [ 24 , 80 – 82 ].…”

Section: Resultsmentioning

confidence: 99%

“…They can have frequent clinic visits, are frequently hospitalised, and have a high risk of critical illness [5][6][7][74][75][76]. These children also have more visits to the Emergency Department than a well child [14,75,[77][78][79]. This rate of attendance is often higher than the rates of attendance of elderly patients over 85 years of age [75].…”

Section: Clinical Care Of the Childmentioning

confidence: 99%

A systematic concept analysis of ‘technology dependent’: challenging the terminology

et al. 2020

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There are an increasing number of children who are dependent on medical technology to sustain their lives. Although significant research on this issue is taking place, the terminology used is variable and the concept of technology dependence is ill-defined. A systematic concept analysis was conducted examining the attributes, antecedents, and consequences of the concept of technology dependent, as portrayed in the literature. We found that this concept refers to a wide range of clinical technology to support biological functioning across a dependency continuum, for a range of clinical conditions. It is commonly initiated within a complex biopsychosocial context and has wide ranging sequelae for the child and family, and health and social care delivery. Conclusion: The term technology dependent is increasingly redundant. It objectifies a heterogenous group of children who are assisted by a myriad of technology and who adapt to, and function with, this assistance in numerous ways.

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Children dependent on respiratory support: A 10‐year review from one pediatric postacute care hospital

Dumas

Hughes

O’Brien

2020

Pediatric Pulmonology

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ObjectivePediatric postacute care hospitals (PACH) provide long‐term care for children with medical complexity including children dependent on respiratory support. Descriptions of PACH respiratory care populations and outcomes, however, remain under‐reported. Our aim was to describe demographics, respiratory outcome, and longitudinal trend of children with respiratory support admitted to a single PACH in the United States.MethodsUsing electronic records from 2009 to 2018, data were examined for all children dependent on respiratory support. Children were identified for inclusion using respiratory level of care classifications (type of support) as outlined in hospital policy. Outcome was defined as change in level from first admission to final discharge. Number of admissions by level and year during the study timeframe were analyzed.ResultsThere were 1423 admissions for 767 children requiring respiratory support during the study timeframe. Children with higher respiratory classification level (eg, mechanical ventilation) at initial admission had more admissions to PACH (P < .001) and longer length of stays (P < .001). From first admission to final discharge, there was a significant change (reduction) in respiratory level (z = −4.588, P < .001). An increase in the overall number of admissions for children with respiratory support during the study timeframe was noted, with the largest increase for children requiring the highest level of support.ConclusionThere has been a consistent increase in the number of children requiring respiratory support at admission to PACH. Reduction in respiratory support with postacute care occurs but children admitted with a higher level of support stay longer and experience multiple admissions.

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Use of Post‐Acute Facility Care in Children Hospitalized With Acute Respiratory Illness

Abstract: Children with RI who are most likely to use PAC have a high prevalence of multiple chronic conditions, multiple medications, and medical technology. Future investigations should assess the supply of PAC against the demand of hospitalized children with RI who might need it.

Cited by 5 publications

References 21 publications

Risk factors for hospitalizations due to bacterial respiratory tract infections after tracheotomy

Risk factors for hospitalizations due to bacterial respiratory tract infections after tracheotomy

A systematic concept analysis of ‘technology dependent’: challenging the terminology

Children dependent on respiratory support: A 10‐year review from one pediatric postacute care hospital

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