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Area of Science:

  • Pediatric Gastroenterology
  • Medical Education
  • Healthcare Management

Background:

  • Caregiver apprehension with pediatric medical devices like gastrostomy tubes (GT) can lead to avoidable emergency department (ED) and acute clinic (AC) visits.
  • Unnecessary visits increase healthcare costs and burden families.
  • Formal education may mitigate these issues.

Purpose of the Study:

  • To evaluate the impact of a preoperative gastrostomy tube (GT) education class on caregiver-related ED/AC visits.
  • To determine if formal GT education reduces inappropriate healthcare utilization post-placement.
  • To assess caregiver self-efficacy in managing children with GTs.

Main Methods:

  • Retrospective cohort study of 1340 pediatric patients receiving GTs (2006-2015).
  • Comparison of unscheduled, GT-related ED/AC visits within one year between trained (class attendees) and untrained caregivers.
  • Classification of visits as appropriate (hospital intervention) or inappropriate (site care/education).

Main Results:

  • 59% of patients experienced an unscheduled GT-related ED/AC visit within one year.
  • The trained cohort showed a 27% reduction in unplanned ED/AC visits (mean 1.21 vs. 1.65).
  • GT education independently decreased one-year GT-related healthcare utilization (OR 0.75, 95% CI 0.59-0.95).

Conclusions:

  • Formal gastrostomy tube (GT) education for caregivers significantly decreases healthcare utilization within one year of placement.
  • Implementing GT education classes can improve caregiver confidence and reduce unnecessary ED/AC visits.
  • GT education should be a standard component of comprehensive care plans for children with medical devices.