Care Models and Discharge Services for Children With Medical Complexity

Authors

Yuliya Oumarbaeva-Malone, Children's National Hospital, Washington DC.
Valerie Jurgens, Children's National Hospital, Washington DC.
Margaret Rush, Children's National Hospital, Washington DC.
Miriam Bloom, Children's National Hospital, Washington DC.
Charity Adusei-Baah, Children's National Hospital, Washington DC.
Matthew Hall, Children's Hospital Association, Lenexa, Kansas.
Neha Shah, Children's National Hospital, Washington DC.
Priti Bhansali, Children's National Hospital, Washington DC.
Kavita Parikh, Children's National Hospital, Washington DC.

Document Type

Journal Article

Publication Date

2-1-2024

Journal

Hospital pediatrics

Volume

14

Issue

2

DOI

10.1542/hpeds.2023-007423

Abstract

BACKGROUND AND OBJECTIVES: Children with medical complexity (CMC) are high health care utilizers prompting hospitals to implement care models focused on this population, yet practices have not been evaluated on a national level. Our objective with this study is to describe the presence and structure of care models and the use of discharge services for CMC admitted to freestanding children's hospitals across the nation. METHODS: We distributed an electronic survey to 48 hospitals within the Pediatric Health Information System exploring the availability of care models and discharge services for CMC. Care models were grouped by type and number present at each institution. Discharge services were grouped by low (never, rarely), medium (sometimes), and high (most of the time, always) frequency use. RESULTS: Of 48 eligible hospitals, 33 completed the survey (69%). There were no significant differences between responders and non-responders for both hospital and patient characteristics. Most participants identified an outpatient care model (67%), whereas 21% had no dedicated care model for CMC in the inpatient or outpatient setting. High-frequency discharge services included durable medical equipment delivery, medication delivery, and communication with outpatient provider before discharge. Low-frequency discharge services included the use of a structured handoff tool for outpatient communication, personalized access plans, inpatient team follow-up with family after discharge, and the use of discharge checklists. CONCLUSIONS: Children's hospitals vary largely in care model structure and discharge services. Future work is needed to evaluate the associations between care models and discharge services for CMC with various health care outcomes.

APA Citation

Oumarbaeva-Malone, Yuliya; Jurgens, Valerie; Rush, Margaret; Bloom, Miriam; Adusei-Baah, Charity; Hall, Matthew; Shah, Neha; Bhansali, Priti; and Parikh, Kavita, "Care Models and Discharge Services for Children With Medical Complexity" (2024). GW Authored Works. Paper 4430.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/4430

Department

Pediatrics