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Dublin Core
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October 2020 List
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October 2020 List
URL Address
<a href="http://doi.org/10.1542/peds.2019-2465" target="_blank" rel="noreferrer noopener">http://doi.org/10.1542/peds.2019-2465</a>
Dublin Core
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Title
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State Variation in Posthospital Home Nursing for Commercially Insured Medically Complex Children
Publisher
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Pediatrics
Date
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2020
Subject
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After Care; Child; Descriptive Statistics; Geographic Factors; Health – Economics; Health Care Costs; Health Services Accessibility; Home Nursing; Human; Insurance; Medically Fragile; Patient Discharge; Probability; Prospective Studies; Retrospective Design
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Rasooly I R; Shults J; Guevara J P; Feudtner C
Description
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BACKGROUND AND OBJECTIVES: Home nursing is essential for children with medical complexity (CMC), but provision varies substantially across states. Our objectives were to quantify state-to-state variability in distribution of posthospitalization home nursing to commercially insured CMC and to rank-order states. METHODS: Retrospective cohort study of hospitalized commercially insured children with ≥1 complex chronic condition from birth to 18 years of age in the Truven MarketScan database. Cohort eligibility criteria were hospital discharge between January 2013 and November 2016 and at least 30 days of follow-up after discharge. Two primary outcome measures were used: receipt of any home nursing within 30 days of hospital discharge (yes or no) and number of days of posthospitalization home nursing (1-30 days). A composite metric encompassing both receipt and quantity was created by evaluating the 95th percentile of days of home nursing (0-30 days). RESULTS: Overall, 9.9% of the sample received home nursing. After we adjusted for patient characteristics, the probability of receiving home nursing varied across states, ranging from 3.4% to 19.2%. Among home nursing recipients, the adjusted median home nursing days across states ranged from 6.6 to 24.5 days. The adjusted 95th percentile of days of home nursing (across the entire of sample, including recipients and nonrecipients of home nursing) ranged from 6.8 to 22.6 days. CONCLUSIONS: We observed striking state-to-state variability in receipt of home nursing and mean number of days of posthospitalization home nursing among commercially insured CMC after adjustment for demographic and clinical differences. This suggests opportunities for state-level improvement.
Identifier
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<a href="http://doi.org/10.1542/peds.2019-2465" target="_blank" rel="noreferrer noopener">10.1542/peds.2019-2465</a>
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Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
2020
After Care
Child
Descriptive Statistics
Feudtner C
Geographic Factors
Guevara J P
Health – Economics
Health Care Costs
Health Services Accessibility
Home Nursing
Human
Insurance
Medically Fragile
October 2020 List
Patient Discharge
Pediatrics
Probability
Prospective Studies
Rasooly I R
Retrospective Design
Shults J