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Home health care, post-acute care in a facility infrequent for hospitalized kids

Hospitalized children infrequently used home health care (HHC) and facility-based post-acute care (PAC) after they were discharged, according to an article published online by JAMA Pediatrics. Jay G. Berry, M.D., M.P.H., of Harvard Medical School, Boston, and coauthors looked at the national prevalence of children discharged to HHC and PAC, as well as the characteristics of those children.

The authors analyzed more than 2.4 million acute care hospital discharges in 2012 for patients 21 and younger from the Agency for Healthcare Research and Quality Kids’ Inpatient Database. The authors report that of more than 2.4 million hospital discharges, 5.1 percent (n=122,673) of discharges were to HHC (for example, visiting or private-duty home nursing) and 1.1 percent (n=26,282) were to PAC facilities (for example, rehabilitation facilities). The most common reason for discharge to HHC was neonatal care; non-neonatal respiratory, musculoskeletal and trauma-related problems were the most common reason for discharge to PAC. Children with four or more chronic conditions compared with children with no chronic conditions were more likely to use HHC and PAC. The authors note their study cannot determine the value or benefit of HHC and PAC in children.

“Further investigation is needed to determine whether the supply and use of these health services in children is sufficient to meet their postdischarge needs, which children may benefit the most from use of these health services, and how integration of these health services in pediatric systems of care might influence health care value and spending,” the study concludes.