Primary care involvement among hospitalized children

Area of Science:

• Pediatric Healthcare
• Health Services Research
• Primary Care Medicine

Background:

• The source of primary care for children is crucial for continuity of care.
• Understanding the involvement of primary care physicians (PCPs) before and during hospitalization is essential for improving pediatric healthcare outcomes.

Purpose of the Study:

• To investigate the relationship between the characteristics of a child's usual primary care source and its involvement in care before and during hospitalization.
• To identify variations in PCP involvement based on geographic location and type of healthcare setting.

Main Methods:

• A retrospective medical record review of 1875 pediatric hospitalizations across five diagnostic groups.
• Data collection from hospitals in Boston, New Haven, and Rochester, NY, for children aged 1 month to 12 years.
• Analysis focused on whether the PCP examined the child pre-admission, referred to the emergency department, or provided in-hospital care.

Main Results:

• Primary care sources were identified in 85.7% of reviewed charts.
• Children in Rochester showed higher rates of pre-admission visits, referrals, and in-hospital care by their PCP compared to those in Boston and New Haven.
• PCP involvement varied significantly by city and type of care source (e.g., health centers, private practices, hospitals), with lower involvement generally observed in Boston and New Haven compared to Rochester.

Conclusions:

• The source of primary pediatric care is demonstrably associated with patterns of prehospital and hospital care.
• Specific associations between primary care source and involvement in care are influenced by geographic location.
• Findings highlight the need to consider the role of primary care in pediatric hospital care and potential disparities in involvement.