The Role of Caregiver-Reported Risks in Predicting Adverse Pediatric Outcomes

• DOI: 10.1093/jpepsy/jsaa067
• Publication Date: 2020-07-15T19:11:42Z
• Authors: Louise E Vaz; David V Wagner; Rebecca M Jungbauer; Katrina L Ramsey; Celeste Jenisch; Natalie Koskela-S...; Steven Everist; Jared P Austin; Michael A Harris; Katharine E Zucke...
• Keywords: Medical record; Odds

Abstract Objective Certain social risk factors (e.g., housing instability, food insecurity) have been shown to directly and indirectly influence pediatric health outcomes; however, there is limited understanding of which are most salient for children admitted the hospital. This study examines how caregiver-reported medical characteristics experiencing an inpatient admission associated with presence future complications. Methods Caregivers (N = 249) completed a predischarge questionnaire designed capture across systems patient, caregiver, family, community, healthcare environment). Electronic record (EHR) data were reviewed child demographic data, chronic disease status, subsequent emergency department visits or readmissions (i.e., acute events) 90 days postindex hospitalization. Associations between event estimated using odds ratios (ORs) confidence intervals (CI), both unadjusted adjusted OR (aOR) age. Results Thirty-three percent 82) experienced at least one event. After accounting age caregiver perceptions child’s being generally “poor” “not good” prior discharge (aOR 4.7, 95% CI 2.3, 9.7), having high care coordination needs 3.2, 1.6, 6.1), difficulty accessing 2.5, 1.4, 4.7) significantly return events. Conclusions Caregiver report risks may provide valuable information above beyond EHR records determine problems inform intervention development.