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Pediatric Hospital-Based Postdischarge Telemedicine Follow-Up Programs: A Scoping Review
Zachary J Tabb1, Tom Harrod2, Kavita Parikh3,4
1Division of Hospital Medicine, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah.
Insights
Postdischarge telemedicine follow-up programs for children are acceptable and identify patient safety issues. However, current evidence does not show these programs reduce hospital readmissions or emergency department visits.
Area of Science:
- Pediatric healthcare delivery
- Digital health interventions
- Patient safety and outcomes
Background:
- Children face health risks after hospital discharge.
- Postdischarge telemedicine follow-up programs may mitigate these risks.
- Limited research exists on their design, focus, and outcomes.
Purpose of the Study:
- To conduct a scoping review of hospital-based postdischarge telemedicine follow-up programs for pediatric patients.
- To report on program design, evaluation, and impact on postdischarge issues and healthcare reutilization.
Main Methods:
- Systematic search of multiple databases (PubMed, CINAHL, Scopus, Web of Science) and gray literature.
- Inclusion of English articles on hospital-based postdischarge telemedicine for pediatric patients (<22 years).
- Data extraction and synthesis of program characteristics and outcomes.
Main Results:
- 17 studies were included; 76% used phone calls, and 76% occurred within 4 days of discharge.
- Identified postdischarge issues (2.9%-85%) related to appointments, medications, and clinical concerns.
- One study showed reduced 14-day ED reutilization; no studies demonstrated reduced readmissions or other ED revisits.
Conclusions:
- Hospital-based postdischarge telemedicine follow-up is acceptable to families and effective in identifying patient safety issues.
- Current evidence does not support the use of these programs for reducing healthcare reutilization.
- Further research is needed to establish the impact on unplanned healthcare use.
Context:
Children discharged from the inpatient setting are at risk for postdischarge health issues. Postdischarge telemedicine follow-up programs (health care visits conducted via phone or video) might address these issues, but their focus, structure, and outcomes have not been collectively studied.
Objective:
To conduct a scoping review reporting on hospital-based postdischarge telemedicine follow-up program design, evaluation, and ability to address postdischarge issues and unplanned health care reutilization.
Data Sources:
PubMed, CINAHL, Scopus, Web of Science, preprints, and gray literature were systematically searched.
Study Selection:
Articles in English that investigated hospital-based postdischarge telemedicine programs for pediatric patients younger than 22 years, not part of a bundle, were included.
Data Extraction:
Data on program and study characteristics and outcomes were extracted and synthesized.
Results:
Of 3407 unique studies identified, 17 were included. Most programs (n = 13, 76%) used phone call follow-up rather than video, and most (n = 13, 76%) follow-up occurred within 4 days. Prevalence of postdischarge issues identified ranged from 2.9% to 85% (median 23.8%, IQR 18.6%, 64.3%), predominantly related to appointments, medications, and clinical concerns. One phone call follow-up observational study showed a reduction in 14-day emergency department (ED) reutilization, but no other studies found reductions in 7-, 14-, or 30-day ED revisit or readmission rates.
Conclusions:
This scoping review found that hospital-based postdischarge telemedicine follow-up programs are acceptable to families and successfully identify wide-ranging postdischarge issues that affect patient safety. However, evidence to date does not demonstrate an effect on reducing health care reutilization.
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