Timely Primary Care Follow-Up Following Hospitalization for Pediatric Critical Illness

Area of Science:

• Pediatric critical care medicine
• Health services research
• Healthcare access and equity

Background:

• Effective recovery after pediatric intensive care unit (PICU) hospitalization relies on timely follow-up care.
• Existing data indicate that regular, timely follow-up is not consistently achieved for these vulnerable children.

Purpose of the Study:

• To determine the rate of timely follow-up care after PICU hospitalization.
• To identify factors associated with timely follow-up with primary and/or specialty care clinicians.

Main Methods:

• Analysis of large US commercial and Medicaid databases (2016-2019).
• Inclusion of children (0-18 years) with PICU hospitalizations.
• Multivariable logistic regression used to assess factors associated with follow-up within 7 days of discharge.

Main Results:

• Less than one-third of publicly and privately insured children had primary care follow-up within 7 days of PICU discharge (24.6% and 29.8%, respectively).
• Subspecialty follow-up rates were also low (8.9% and 9.9%).
• Younger age and absence of complex chronic conditions were linked to a higher likelihood of primary care follow-up.

Conclusions:

• A significant gap exists in timely post-PICU care, with fewer than one-third of children receiving recommended primary care follow-up within a week.
• Specific patient characteristics, such as age and chronic condition status, influence follow-up rates.
• Developing targeted interventions is crucial to ensure continuity of care for children surviving critical illness.