Issues Identified by Postdischarge Contact after Pediatric Hospitalization: A Multisite Study

BACKGROUND: Many hospitals are considering contacting hospitalized patients soon after discharge to help with issues that arise.

OBJECTIVES: To (1) describe the prevalence of contact-identified postdischarge issues (PDI) and (2) assess characteristics of children with the highest likelihood of having a PDI.

DESIGN, SETTING, AND PATIENTS: A retrospective analysis of hospital-initiated follow-up contact for 12,986 children discharged from January 2012 to July 2015 from 4 US children’s hospitals. Contact was made within 14 days of discharge by hospital staff via telephone call, text message, or e-mail. Standardized questions were asked about issues with medications, appointments, and other PDIs. For each hospital, patient characteristics were compared with the likelihood of PDI by using logistic regression.

RESULTS: Median (interquartile range) age of children at admission was 4.0 years (0-11); 59.9% were non-Hispanic white, and 51.0% used Medicaid. The most common reasons for admission were bronchiolitis (6.3%), pneumonia (6.2%), asthma (5.1%), and seizure (4.9%). Twenty-five percent of hospitalized children (n = 3263) reported a PDI at contact (hospital range: 16.0%-62.8%). Most (76.3%) PDIs were related to follow-up appointments (eg, difficulty getting one); 20.8% of PDIs were related to medications (eg, problems filling a prescription). Patient characteristics associated with the likelihood of PDI varied across hospitals. Older age (age 10-18 years vs <1 year) was significantly (P < .001) associated with an increased likelihood of PDI in 3 of 4 hospitals.

CONCLUSIONS: PDIs were identified often through hospital-initiated follow-up contact. Most PDIs were related to appointments. Hospitals caring for children may find this information useful as they strive to optimize their processes for follow-up contact after discharge.