Related Experiment Video
Updated: Feb 25, 2026
Halogenated Agent Delivery in Porcine Model of Acute Respiratory Distress Syndrome via an Intensive Care Unit Type Device
Published on: September 24, 2020
Use of Post-Acute Facility Care in Children Hospitalized With Acute Respiratory Illness
Jay Berry1,2, Karen Wilson3, Helene Dumas2
1Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Insights
Children hospitalized with respiratory illness (RI) who have multiple chronic conditions, medications, or technology are most likely to need post-acute care (PAC). This highlights a potential gap between the demand for and supply of PAC services for these vulnerable pediatric patients.
Area of Science:
- Pediatric healthcare research
- Health services research
- Respiratory medicine
Background:
- Respiratory illness (RI) is a frequent cause of hospitalization in children.
- Recovery can be prolonged for children with severe RI or complex medical needs.
- Identifying children at high risk for extended recovery is crucial for resource allocation.
Purpose of the Study:
- To determine which hospitalized children with RI are most likely to require post-acute facility care (PAC).
- To understand the characteristics associated with PAC utilization in pediatric RI hospitalizations.
Main Methods:
- Retrospective analysis of 609,800 pediatric hospitalizations for RI across 43 US children's hospitals (2010-2015).
- Identification of PAC discharges using Medicare and Medicaid data.
- Comparison of patient characteristics between children discharged to PAC and those not.
Main Results:
- 0.4% of RI hospitalizations (n=2660) resulted in PAC transfer.
- Children discharged to PAC had higher rates of technology dependence (83.2%), neuromuscular conditions (57.5%), and mechanical ventilation (52.7%).
- High likelihood of PAC use was associated with multiple chronic conditions (OR 11.7), numerous medications (OR 4.8), and tracheostomy (OR 3.0).
Conclusions:
- Hospitalized children with RI requiring PAC often present with complex medical needs, including multiple comorbidities and technology dependence.
- The findings suggest a significant demand for PAC among these children.
- Further research is needed to evaluate the capacity of PAC services to meet the projected demand for pediatric RI patients.
Background:
Recovery from respiratory illness (RI), a common reason for hospitalization, can be protracted for some children because of high illness severity or underlying medical complexity.
Objective:
We assessed which children hospitalized with RI are the most likely to use post-acute facility care (PAC) for recovery.
Methods:
Retrospective analysis of 609,800 hospitalizations for patients in 43 US children's hospitals between 2010- 2015 for RI, identified with the Agency for Healthcare Research and Quality Clinical Classification System. Discharge to PAC was identified using Centers for Medicare & Medicaid Services Discharge Status Codes. We compared patient characteristics by PAC use with generalized estimating equations.
Results:
There were 2660 (0.4%) RI hospitalizations resulting in PAC transfer (n = 2660, 0.4%). Discharges to PAC had greater percentages of technology assistance (83.2% vs 15.1%), neuromuscular chronic condition (57.5% vs 8.9%), and mechanical ventilation (52.7% vs 9.1%), 𝑃 < 0.001 for all. The highest likelihood of PAC use occurred with ≥11 vs no chronic conditions (odds ratio [OR] 11.7 [95% CI, 8.0- 17.2]), ≥9 vs no therapeutic medication classes (OR 4.8 [95% CI, 1.8-13.0]), and existing tracheostomy (OR 3.0, 95% confidence interval [CI], 2.6-3.5). Median (interquartile range [IQR]) acute-care length of stay (LOS) for children most likely to use PAC was 19 (8-56) days; LOS remained long (median 13 [6-41] days) for children with the same attributes (n = 9448) not transferred to PAC.
Conclusions:
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.
Related Concept Videos
01:29Acute Respiratory Failure-V
Ensure that patients are monitored continuously for their response to therapy, including changes in...
01:28Pneumonia IV: Management
Bacterial Pneumonia Treatment
For bacterial pneumonia, antibiotics serve as the cornerstone of therapy. Initial treatment often begins with empirical antibiotics, tailored to the anticipated causative organism and adjusted based on culture results. Key antibiotic choices include:
01:21Acute Respiratory Failure-II
The underlying physiological abnormalities that contribute to hypoxemic respiratory failure include:
01:19Restorative Care
01:21Acute Respiratory Failure-I
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...
01:30Acute Respiratory Failure-III