Technology-dependency Among Patients Discharged From a Children's Hospital: A Retrospective Cohort Study

BMC Pediatr. 2005 May 9;5(1):8. doi: 10.1186/1471-2431-5-8.

Abstract

Background: Advances in medical technology may be increasing the population of children who are technology-dependent (TD). We assessed the proportion of children discharged from a children's hospital who are judged to be TD, and determined the most common devices and number of prescription medications at the time of discharge.

Methods: Chart review of 100 randomly selected patients from all services discharged from a children's hospital during the year 2000. Data were reviewed independently by 4 investigators who classified the cases as TD if the failure or withdrawal of the technology would likely have adverse health consequences sufficient to require hospitalization. Only those cases where 3 or 4 raters agreed were classified as TD.

Results: Among the 100 randomly sampled patients, the median age was 7 years (range: 1 day to 24 years old), 52% were male, 86% primarily spoke English, and 54% were privately insured. The median length of stay was 3 days (range: 1 to 103 days). No diagnosis accounted for more than 5% of cases. 41% were deemed to be technology dependent, with 20% dependent upon devices, 32% dependent upon medications, and 11% dependent upon both devices and medications. Devices at the time of discharge included gastrostomy and jejeunostomy tubes (10%), central venous catheters (7%), and tracheotomies (1%). The median number of prescription medications was 2 (range: 0-13), with 12% of cases having 5 or more medications. Home care services were planned for 7% of cases.

Conclusion: Technology-dependency is common among children discharged from a children's hospital.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Catheterization, Central Venous
  • Child
  • Child, Preschool
  • Cohort Studies
  • Disabled Children*
  • Drug Therapy*
  • Female
  • Home Nursing*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Nebulizers and Vaporizers
  • Ostomy
  • Patient Discharge
  • Retrospective Studies
  • Ventriculoperitoneal Shunt