Evidence map›Paper›PMID 38485760›Full record

ArticlePediatric cardiology2024

Risk Factors and Outcomes Associated with Gaps in Care in Children with Congenital Heart Disease.

Michael B Rosamilia, Jason Williams, Courtney A Bair, Hillary Mulder, Karen E Chiswell, Alfred A D'Ottavio, Robert J Hartman, Charlie J Sang, Karl F Welke, Michael J Walsh and 4 more

Open access · hybridAbstract read
In one paragraph

Article in Pediatric cardiology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.5field-weighted citation impact, top 18% 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

3 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
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

14 authors at 6 institutions in 1 country.

Michael B RosamiliaDuke University School of Medicine, Durham, NC, USA.
Jason WilliamsDepartment of Pediatrics, Division of Pediatric Cardiology, Duke School of Medicine, Durham, NC, USA.
Courtney A BairDuke University School of Medicine, Durham, NC, USA.
Hillary MulderDuke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA.
Karen E ChiswellDuke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA.
Alfred A D'OttavioDuke Clinical Research Institute, Duke University Medical Center, Durham, NC, USA.
Robert J HartmanDepartment of Pediatrics, Division of Pediatric Cardiology, University of North Carolina at Chapel Hill Medical Center, Chapel Hill, NC, USA.
Charlie J SangDepartment of Pediatrics, Division of Pediatric Cardiology, East Carolina University, Greenville, NC, USA.
Karl F WelkeDepartment of Surgery, Division of Pediatric Cardiothoracic Surgery, Atrium Health Levine Children's Hospital, Charlotte, NC, USA.
Michael J WalshDepartment of Pediatrics, Division of Pediatric Cardiology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Timothy M HoffmanDepartment of Pediatrics, Division of Pediatric Cardiology, University of North Carolina at Chapel Hill Medical Center, Chapel Hill, NC, USA.
Andrew P LandstromDepartment of Pediatrics, Division of Pediatric Cardiology, Duke School of Medicine, Durham, NC, USA.
Jennifer S LiDepartment of Pediatrics, Division of Pediatric Cardiology, Duke School of Medicine, Durham, NC, USA.
Lauren A SarnoDepartment of Pediatrics, Division of Pediatric Cardiology, East Carolina University, Greenville, NC, USA. sarnol18@ecu.edu.ORCID http://orcid.org/0000-0001-5925-8733
Clinical Research Institute · USDuke University · USEast Carolina University · USUniversity of North Carolina at Chapel Hill · USLevine Children's Hospital · USWake Forest University · US

Funding

NRSA Training CoreTL1TR002555 · NCATS · DUKE UNIVERSITY · PI EDELMAN, DAVID · 2018 to 2022
$3.7M
NCATS NIH HHS TL1 TR002555
6 · The paper itself

Abstract

Adults with congenital heart disease (CHD) benefit from cardiology follow-up at recommended intervals of ≤ 2 years. However, benefit for children is less clear given limited studies and unclear current guidelines. We hypothesize there are identifiable risks for gaps in cardiology follow-up in children with CHD and that gaps in follow-up are associated with differences in healthcare utilization. Our cohort included children < 10 years old with CHD and a healthcare encounter from 2008 to 2013 at one of four North Carolina (NC) hospitals. We assessed associations between cardiology follow-up and demographics, lesion severity, healthcare access, and educational isolation (EI). We compared healthcare utilization based on follow-up. Overall, 60.4% of 6,969 children received cardiology follow-up within 2 years of initial encounter, including 53.1%, 58.1%, and 79.0% of those with valve, shunt, and severe lesions, respectively. Factors associated with gaps in care included increased drive time to a cardiology clinic (Hazard Ratio (HR) 0.92/15-min increase), EI (HR 0.94/0.2-unit increase), lesion severity (HR 0.48 for shunt/valve vs severe), and older age (HR 0.95/month if < 1 year old and 0.94/year if > 1 year old; p < 0.05). Children with a care gap subsequently had more emergency department (ED) visits (Rate Ratio (RR) 1.59) and fewer inpatient encounters and procedures (RR 0.51, 0.35; p < 0.05). We found novel factors associated with gaps in care for cardiology follow-up in children with CHD and altered health care utilization with a gap. Our findings demonstrate a need to mitigate healthcare barriers and generate clear cardiology follow-up guidelines for children with CHD.

Indexed as

Heart Defects, CongenitalChildChild, PreschoolFemaleFollow-Up StudiesHealth Services AccessibilityHumansInfantInfant, NewbornMaleNorth CarolinaPatient Acceptance of Health CareRetrospective StudiesRisk FactorsAftercareCongenital heart diseaseHealth care utilizationSocial determinants of health

Identifiers

PMID38485760
PMCPMC11056317
OpenAlexW4392796797

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.