Outpatient Follow-up Care After Hospital Discharge of Children With Complex Chronic Conditions at a Rural Tertiary...

Area of Science:

• Pediatric Healthcare
• Chronic Disease Management
• Health Services Research

Background:

• Children with complex chronic conditions (CCCs) require coordinated care post-hospitalization.
• Completion of recommended outpatient follow-up is crucial for managing CCCs.
• Factors influencing follow-up adherence in this population are not fully understood.

Purpose of the Study:

• To identify factors associated with completing recommended outpatient follow-up visits.
• To understand post-discharge care needs for children with CCCs.
• To inform strategies for improving follow-up adherence.

Main Methods:

• Retrospective study of children (1-17 years) with CCCs discharged from a rural tertiary children's hospital (2017-2018).
• Exclusion of neonatal intensive care unit discharges and those in existing care coordination programs.
• Analysis of factors associated with follow-up completion based on discharge instructions.

Main Results:

• 68% of eligible children completed recommended outpatient follow-up.
• Intensive care unit (ICU) admission was linked to a lower likelihood of follow-up.
• Prolonged length of stay was also associated with decreased follow-up completion.

Conclusions:

• ICU admission independently predicts reduced follow-up completion in children with CCCs.
• Children with CCCs not in care coordination programs and with ICU stays are at high risk.
• Expanded care coordination efforts should target this vulnerable population.