Evidence map›Paper›PMID 30053631›Full record

ArticleAcademic pediatrics

Perceived Access to Outpatient Care and Hospital Reutilization Following Acute Respiratory Illnesses.

Chén C Kenyon, Siobhan M Gruschow, Wren L Haaland, Arti D Desai, Sarah A Adams, Talia A Hitt, Derek J Williams, David P Johnson, Rita Mangione-Smith

Abstract read
In one paragraph

Article in Academic pediatrics. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Chén C KenyonCenter for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, University of Pennsylvania School of Medicine, Philadelphia, PA. Electronic address: kenyonc@email.chop.edu.
Siobhan M GruschowCenter for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, PA.
Wren L HaalandDepartment of Pediatrics, University of Washington and the Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA.
Arti D DesaiDepartment of Pediatrics, University of Washington and the Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA.
Sarah A AdamsCenter for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, PA.
Talia A HittCenter for Pediatric Clinical Effectiveness, The Children's Hospital of Philadelphia, Philadelphia, PA.
Derek J WilliamsDivision of Hospital Medicine, Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt, Vanderbilt University School of Medicine, Nashville, Tenn .
David P JohnsonDivision of Hospital Medicine, Department of Pediatrics, Monroe Carell Jr Children's Hospital at Vanderbilt, Vanderbilt University School of Medicine, Nashville, Tenn .
Rita Mangione-SmithDepartment of Pediatrics, University of Washington and the Center for Child Health, Behavior, and Development, Seattle Children's Research Institute, Seattle, WA.

Funding

Pediatric Respiratory Illness Measurement System (PRIMES) Implementation in Community Hospital SettingsR01HL121067 · NHLBI · SEATTLE CHILDREN'S HOSPITAL · PI MANGIONE-SMITH, RITA · 2014 to 2025
$6.4M
Incentive-based Mobile Health Adherence Intervention for High Risk Children with AsthmaK23HL136842 · NHLBI · CHILDREN'S HOSP OF PHILADELPHIA · PI KENYON, CHEN COLLIN · 2019 to 2023
$908k
Web-based Care Plans for Children with Medical ComplexityK08HS024299 · AHRQ · SEATTLE CHILDREN'S HOSPITAL · PI DESAI, ARTI D · 2015 to 2019
$741k
AHRQ HHS K08 HS024299NHLBI NIH HHS K23 HL136842NHLBI NIH HHS R01 HL121067
6 · The paper itself

Abstract

objectiveEfforts to decrease hospital revisits often focus on improving access to outpatient follow-up. Our objective was to assess the relationship between perceived access to timely office-based care and subsequent 30-day revisits following hospital discharge for 4 common respiratory illnesses.

methodsThis was a prospective cohort study of children 2 weeks to 16years admitted to 5 US children's hospitals for asthma, bronchiolitis, croup, or pneumonia between July 2014 and June 2016. Hospital and emergency department (ED) (in the case of croup) admission surveys administered to caregivers included the Consumer Assessments of Healthcare Providers and Systems Timely Access to Care. Access composite scores (range 0-100, with greater scores indicating better access) were linked with 30-day ED revisits and inpatient readmissions from the Pediatric Health Information System. The relationship between access to timely care and repeat utilization was assessed using multivariable logistic regression adjusting for demographics, hospitalization, and home/outpatient factors.

resultsOf the 2438 children enrolled, 2179 (89%) reported an office visit in the previous 6 months. Average access composite score was 52.0 (standard deviation, 36.3). In adjusted analyses, greater access scores were associated with greater odds of 30-day ED revisits (odds ratio [OR] = 1.07; 95% confidence interval [CI], 1.02-1.13)-particularly for croup (OR = 1.17; 95% CI, 1.02-1.36)-but not inpatient readmissions (OR = 1.02; 95% CI, 0.96-1.09).

conclusionsPerceived access to timely office-based care was associated with significantly greater odds of subsequent ED revisit. Focusing solely on enhancing timely access to care following discharge for common respiratory illnesses may be insufficient to prevent repeat utilization.

Indexed as

Acute DiseaseAdolescentAmbulatory CareChildChild, PreschoolEmergency Service, HospitalFemaleHealth Services AccessibilityHospitalsHumansInfantInfant, NewbornLogistic ModelsMaleProspective StudiesRespiratory Tract Diseasesaccess to careacute respiratory illnesshospitalizationreadmissions

Identifiers

PMID30053631
PMCPMC6347552

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.