Complex Care Hospital Use and Postdischarge Coaching: A Randomized Controlled Trial

Pediatrics
Ryan J CollerPaul J Chung

Abstract

We sought to examine the effect of a caregiver coaching intervention, Plans for Action and Care Transitions (PACT), on hospital use among children with medical complexity (CMC) within a complex care medical home at an urban tertiary medical center. PACT was an 18-month caregiver coaching intervention designed to influence key drivers of hospitalizations: (1) recognizing critical symptoms and conducting crisis plans and (2) supporting comprehensive hospital transitions. Usual care was within a complex care medical home. Primary outcomes included hospitalizations and 30-day readmissions. Secondary outcomes included total charges and mortality. Intervention effects were examined with bivariate and multivariate analyses. From December 2014 to September 2016, 147 English- and Spanish-speaking CMC <18 years old and their caregivers were randomly assigned to PACT (n = 77) or usual care (n = 70). Most patients were Hispanic, Spanish-speaking, and publicly insured. Although in unadjusted intent-to-treat analyses, only charges were significantly reduced, both hospitalizations and charges were lower in adjusted analyses. Hospitalization rates (per 100 child-years) were 81 for PACT vs 101 for usual care (adjusted incident rate ratio: 0.61 ...Continue Reading

References

Oct 28, 1998·Archives of Pediatrics & Adolescent Medicine·G S LiptakE R McAnarney
Jul 27, 2001·Journal of Health Economics·W G Manning, J Mullahy
Sep 27, 2006·Archives of Internal Medicine·Eric A ColemanSung-Joon Min
Feb 6, 2008·Archives of Pediatrics & Adolescent Medicine·Roger L ZemekFrancine M Ducharme
Nov 26, 2009·Professional Case Management·Monique M ParrishEric A Coleman
Feb 18, 2011·JAMA : the Journal of the American Medical Association·Jay G BerryJohn Neff
Jun 26, 2014·Pediatric Blood & Cancer·Lakshmanan KrishnamurtiRichard Saladino
Dec 10, 2014·Health Affairs·Jay G BerryChris Feudtner
Dec 24, 2014·JAMA : the Journal of the American Medical Association·Ricardo A MosqueraJon E Tyson
Jun 5, 2015·Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality·Eric A ColemanSung-Joon Min
Aug 8, 2015·Journal of Child Neurology·Lindsi M RoundyJoshua L Bonkowsky
Oct 7, 2015·Pediatrics·Shawn L RalstonDavid C Goodman
Nov 4, 2015·Pediatrics·Ryan J CollerPaul J Chung
Oct 21, 2016·Journal for Healthcare Quality : Official Publication of the National Association for Healthcare Quality·Patricia M BranowickiJay G Berry
Dec 13, 2016·Pediatrics·James C GayJay G Berry
Mar 28, 2017·Journal of Pediatric Nursing·Sarah WellsJay G Berry

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Citations

Nov 30, 2019·Child: Care, Health and Development·Wendy S LoomanElizabeth V Weinfurter
Aug 7, 2019·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Katherine A AugerMatthew M Davis
Oct 25, 2020·Journal for Specialists in Pediatric Nursing : JSPN·Lori J WilliamsAnne L Ersig
Dec 1, 2020·JAMA Pediatrics·Chris Feudtner, Annique K Hogan
Dec 1, 2020·The Journal of Pediatrics·Ryan J CollerPaul J Chung
Feb 23, 2021·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Jessica L MarkhamJay G Berry
Apr 23, 2021·International Journal of Care Coordination·Neal A deJongMichael D Kappelman
Sep 4, 2021·Pediatric Quality & Safety·Christina B BarredaRyan J Coller
Sep 19, 2021·Hospital Pediatrics·Karen PughLouis Ehwerhemuepha
Mar 13, 2021·Pediatrics·Audrey UongMichael L Rinke

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