Evidence map›Paper›PMID 36775189›Full record

ArticleThe Journal of pediatrics2023

Paying Family Medical Caregivers for Children's Home Healthcare in Colorado: A Working Medicaid Model.

Carolyn C Foster, Soyang Kwon, Christy Blakely, Kristin Carter, Sarah A Sobotka, Denise M Goodman, Rishi Agrawal, Mark Brittan

Open access · hybridAbstract read
In one paragraph

Article in The Journal of pediatrics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
8.6field-weighted citation impact, top 3% of its field
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

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Guideline
  2. Article
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 1 country.

Carolyn C FosterDivision of Advanced General Pediatrics and Primary Care, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL; Mary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL. Electronic address: ccfoster@luriechildrens.org.
Soyang KwonMary Ann & J. Milburn Smith Child Health Outcomes, Research, and Evaluation Center, Stanley Manne Children's Research Institute, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
Christy BlakelyFamily Voices Colorado, Centennial, CO.
Kristin CarterDivision of Palliative Care, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
Sarah A SobotkaSection of Developmental and Behavioral Pediatrics, Department of Pediatrics, The University of Chicago, Chicago, IL.
Denise M GoodmanDivision of Critical Care Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
Rishi AgrawalDivision of Hospital Based Medicine, Department of Pediatrics, Northwestern University Feinberg School of Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL.
Mark BrittanSection of Pediatric Hospital Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO; Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado, Aurora, CO.
Northwestern University · USLurie Children's Hospital · USUniversity of Chicago · USUniversity of Colorado Hospital · US

Funding

HOMeVent4Kids: Home-based Optimization of Mechanical Ventilation for ChildrenK23HL149829 · NHLBI · LURIE CHILDREN'S HOSPITAL OF CHICAGO · PI FOSTER, CAROLYN C. · 2020 to 2024
$775k
Predictors of Days at Home for Children with Mechanical Ventilator AssistanceK23HD097276 · NICHD · UNIVERSITY OF CHICAGO · PI SOBOTKA, SARAH ANN · 2019 to 2021
$474k
NHLBI NIH HHS K23 HL149829NICHD NIH HHS K23 HD097276
6 · The paper itself

Abstract

objectiveTo compare the characteristics and healthcare use of children with medical complexity who receive paid certified nursing assistant (CNA) care by a family member (family CNA) and by a traditional nonfamily member (nonfamily CNA). STUDY

designThis was retrospective cohort study of children who received CNA care through Colorado's Medicaid paid family caregiving program between 2017 and 2019 by a home healthcare agency. We compared patient characteristics between the family CNA and nonfamily CNA groups. A multivariable Poisson regression model was used to compare hospitalization rates (days in the hospital per year), adjusting for patient age patient sex, nursing care, and complex chronic condition.

resultsOf 861 patients, 79% (n = 680) received family CNA care and 21% (n = 181) received nonfamily CNA care. Patient demographics and hospitalization did not differ between the groups, although patients who had family CNAs were less likely to receive additional nursing-level care (42% vs 60%, P < .01). Family and nonfamily CNA caregivers had similar characteristics, except that family CNA caregivers had substantially better 3-year retention (82% vs 9%, P < .01) despite lower average hourly pay ($14.60 vs $17.60 per hour, P < .01). Hospitalizations were rare (<10% of patients). In the adjusted model, patients who received family CNA care experienced 1 more hospitalized day per year, compared with patients who received nonfamily CNA care (P < .001).

conclusionsPaid family caregivers provided CAN-level care to children with medical complexity with a greater employee retention compared with nonfamily CNA caregivers, with marginally different hospitalization rates using a family-centered approach. This model may help address workforce shortages while also providing income to family caregivers.

Indexed as

CaregiversMedicaidChildColoradoHealth Services Needs and DemandHumansRetrospective StudiesUnited Statescaregivingchildren with medical complexitychildren with special health care needsMedicaid

Identifiers

PMID36775189
PMCPMC10412725
OpenAlexW4319873454

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.