Identifying Pediatric Patients at High Risk for Failure to Achieve Continuity of Care at Hospital Discharge

1University of Arizona, Tucson, AZ
2University of Arizona, Tucson, AZ
3University of Arizona, Tucson, AZ

Meeting: Hospital Medicine 2010, April 8-11, Washington, D.C.

Abstract number: 63

Background:

Increasing numbers of hospitalized infants and children are cared for by pediatric hospitalists. Transitions in care and transfer‐of‐care providers at the time of hospital discharge place patients at risk for failure to achieve postdischange continuity of care, which is defined as: (1) failure to comply with the prescribed discharge medical regimen and (2) failure to obtain timely medical follow‐up. The Society of Hospital Medicine's BOOST initiative identifies characteristics in elderly patients that increase their risk for failure to achieve continuity of care at hospital discharge. Identification of pediatric patients at high risk for failure in continuity of care at hospital discharge has the potential to improve rates of follow‐up and medical compliance and reduce preventable health care failures. This project aims to identify patient/parent characteristics that increase pediatric patients' risk for failure to achieve continuity of care at hospital discharge.

Methods:

One hundred and one eligible pediatric patients at University Medical Center were enrolled. An inpatient demographics questionnaire was administered to parents. A chart review to determine additional patient/parent characteristics was conducted. Within 72 hours of discharge, a follow up phone call questionnaire was conducted to determine patient's continuity of care and parental satisfaction. The main outcomes measured were; (1) parent knowledge of the date of the patient's follow‐up appointment and (2) patient compliance with all prescribed scheduled medications. An analysis of demographic and medical need factors associated with the main outcomes was conducted. Project approval was granted by the institutional review board.

Results:

Pediatric patients whose parent was less likely to know the date of their follow‐up appointment were those that were 11 years of age or older (P = 0.01), had a diagnosed psychiatric condition (P = 0.03), lacked medical insurance (P = 0.02), did not have an appointment made for them by the hospital staff prior to discharge (P = 0.04), and whose parent was dissatisfied with the doctor's explanations of tests, treatments, and/or procedures (P = 0.01). Patients were less likely to be taking all prescribed scheduled medications if their parent was dissatisfied with physicians' explanations of tests, treatments, and/or procedures (P < 0.001) and if the parent was dissatisfied with physician communication (P < 0.001).

Conclusions:

This study identified patient/parent characteristics that increase the risk for failure to achieve continuity of care at the time of hospital discharge in pediatric patients. Identification of these high‐risk characteristics will enable pediatric hospitalists to intervene early to improve medical compliance and follow‐up and reduce preventable health care failures following hospital discharge of infants and children.

Author Disclosure:

C. Hardin, none; C. Okorie, none; N. Gruchala, none.

To cite this abstract:

Hardin C, Okorie C, Gruchala N. Identifying Pediatric Patients at High Risk for Failure to Achieve Continuity of Care at Hospital Discharge. Abstract published at Hospital Medicine 2010, April 8-11, Washington, D.C. Abstract 63. Journal of Hospital Medicine. 2010; 5 (suppl 1). https://www.shmabstracts.com/abstract/identifying-pediatric-patients-at-high-risk-for-failure-to-achieve-continuity-of-care-at-hospital-discharge/. Accessed July 24, 2019.

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