Issues Identified by Postdischarge Contact after Pediatric Hospitalization: A Multisite Study

J Hosp Med. 2018 Apr;13(4):236-242. doi: 10.12788/jhm.2934. Epub 2018 Feb 2.


Background: Many hospitals are considering contacting hospitalized patients soon after discharge to help with issues that arise.

Objective: To (1) describe the prevalence of contactidentified postdischarge issues (PDI) and (2) assess characteristics of children with the highest likelihood of having a PDI.

Design, setting, patients: A retrospective analysis of hospital-initiated follow-up contact for 12,986 children discharged from January 2012 to July 2015 from 4 US children's hospitals. Contact was made within 14 days of discharge by hospital staff via telephone call, text message, or e-mail. Standardized questions were asked about issues with medications, appointments, and other PDIs. For each hospital, patient characteristics were compared with the likelihood of PDI by using logistic regression.

Results: Median (interquartile range) age of children at admission was 4.0 years (0-11); 59.9% were nonHispanic white, and 51.0% used Medicaid. The most common reasons for admission were bronchiolitis (6.3%), pneumonia (6.2%), asthma (5.1%), and seizure (4.9%). Twenty-five percent of hospitalized children (n=3263) reported a PDI at contact (hospital range: 16.0%-62.8%). Most (76.3%) PDIs were related to follow-up appointments (eg, difficulty getting one); 20.8% of PDIs were related to medications (eg, problems filling a prescription). Patient characteristics associated with the likelihood of PDI varied across hospitals. Older age (age 10-18 years vs <1 year) was significantly (P<.001) associated with an increased likelihood of PDI in 3 of 4 hospitals.

Conclusions: PDIs were identified often through hospital-initiated follow-up contact. Most PDIs were related to appointments. Hospitals caring for children may find this information useful as they strive to optimize their processes for follow-up contact after discharge.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aftercare / methods*
  • Bronchiolitis / diagnosis
  • Bronchiolitis / drug therapy
  • Child, Preschool
  • Female
  • Hospitalization*
  • Hospitals, Pediatric*
  • Humans
  • Male
  • Patient Discharge*
  • Pneumonia / diagnosis
  • Pneumonia / drug therapy
  • Retrospective Studies
  • United States