Caregiver Engagement During Pediatric Post-Acute Care Hospitalization

Area of Science:

• Pediatric Healthcare
• Caregiver Support
• Health Services Research

Background:

• Caregiver engagement in acute care settings offers significant benefits for children, including improved developmental and behavioral outcomes.
• Existing research on caregiver engagement is concentrated in acute care, leaving a gap in understanding its dynamics within pediatric post-acute care hospitals (pPACH).

Purpose of the Study:

• To explore and characterize caregiver engagement patterns within a pediatric post-acute care hospital (pPACH) setting.
• To identify demographic and clinical factors associated with caregiver engagement in pPACH.

Main Methods:

• A retrospective review of electronic health records for 614 patients aged 0-23 years admitted to a Northeastern US pPACH between 2013 and 2017.
• Caregiver engagement was defined by patient visits and telephone calls.
• Descriptive statistics and multivariable logistic regression were employed to analyze associations between patient demographics and caregiver engagement.

Main Results:

• Caregiver visits were the predominant form of engagement, with telephone calls being less frequent.
• Factors associated with significantly higher odds of caregiver visits included patient age (1-17 years), private insurance, and a single admission.
• Conversely, lower odds of caregiver visits were observed in infants (<1 year), older patients (≥18 years), those with multiple admissions (≥2), public insurance, Child Protective Services (CPS) involvement, and specific racial/ethnic minority groups.

Conclusions:

• Infants, patients with multiple admissions, those with CPS involvement, and those covered by public payers demonstrated lower rates of caregiver visits.
• Further research and targeted strategies are essential to identify and overcome barriers to caregiver engagement in pPACH settings.