Family-Reported Posthospitalization Outcomes for Children With Complex Chronic Disease
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View abstract on PubMed
Summary
This summary is machine-generated.Families of children with complex chronic disease (CCD) found new measures for hospital-to-home transition effective. Many children did not return to baseline health within 30 days, highlighting the need for improved transition support.
Area Of Science
- Pediatric Healthcare
- Health Services Research
- Patient-Reported Outcomes
Background
- Children with complex chronic disease (CCD) face significant challenges during hospital-to-home transitions, leading to high rates of unplanned healthcare use.
- Existing transition effectiveness measures often lack input from families of children with CCD, limiting their relevance and applicability.
- Developing family-centered outcomes is crucial for improving care transitions in this vulnerable population.
Purpose Of The Study
- To identify patient- and family-reported outcomes (PROs) that are most meaningful to families of children with CCD regarding hospital-to-home transition effectiveness.
- To assess the feasibility, acceptability, and variability of these family-identified PROs among recently discharged children with CCD.
- To develop and validate new PRO measures for transition effectiveness in pediatric complex chronic disease.
Main Methods
- Family members of children with CCD participated in design sessions to develop and refine PRO measures for transition effectiveness.
- A prospective cohort study was conducted with 102 hospitalized children with CCD, collecting transition measures 7 days post-discharge.
- Transition measures were compared with 30-day unplanned readmission rates using correlation analysis to assess predictive validity.
Main Results
- Families endorsed existing transition measures and co-created a 'Return to Baseline' measure, assessing progress toward pre-hospitalization status.
- In the cohort study, families reported high satisfaction with the transition measures, though many children (64.7% at 7 days, 62.4% at 30 days) had not returned to baseline health.
- Early return to baseline (at 7 days) concerning child health, routine, work, and sleep showed a moderate correlation with reduced 30-day unplanned readmissions.
Conclusions
- Several family-centered transition measures were endorsed by families of children with CCD, indicating their relevance and acceptability.
- A significant proportion of children with CCD did not achieve baseline health status by 7 or 30 days post-hospitalization, underscoring transition difficulties.
- Future research on hospital-to-home transition interventions for children with CCD should incorporate PROs and health utilization outcomes to evaluate effectiveness.
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