Children with Medical Complexity (CMC) often require 24/7 expert care, which may impede discharge from hospital to home (H2H) resulting in prolonged admission. Limited research exists on pediatric patients with delayed discharges and the underlying reasons for such extended admissions. Therefore, our objectives were to (1) describe the demographics, clinical characteristics, and course of CMC who are in their H2H transition and (2) identify the reasons for postponement of H2H discharge. Prospective, multicenter, observational cohort study performed from February 2022 until November 2022 for 6 months in four Dutch University Medical Center children's hospitals. Clinically admitted patients (age 0-18 years) were eligible for inclusion if they were medically stable, yet required specialized nursing and/or paramedical care and were in the H2H transition process. In total, 44 participants were included, of whom 32 (72.7%) were younger than 1 year. Median stay in the hospital was 7.3 weeks (range 0.7-28.7). Upon entering the H2H phase, postponement of discharge was for 65.1% of the patients primarily due to a combination of medical reasons and organizational/family factors. For the remaining 34.9% of the patients, discharge was delayed solely due to organizational and/or family factors. CONCLUSION : Our study highlights several reasons contributing to the postponement of discharge for pediatric patients with medical complexity, including their medical fragility, the time-consuming process of parent training, and the challenges in organizing home care. Future steps should explore various transitional care programs aimed at improving the H2H transition. What is Known: • Hospital to home transition for Children with Medical Complexity is a multi-faceted process with many challenges and obstacles • Insight into the current practice of transitioning home in University Medical Centers remains unknown and is needed to develop a tailored yet standardized approach What is New: • Our findings reveal reasons for postponement of discharge home and show that patients are medically stable for more than half of their hospital stays. This indicates potential opportunities to reorganize care for better outcomes for the child, the family, and healthcare consumption.
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http://dx.doi.org/10.1007/s00431-024-05960-2 | DOI Listing |
Curr Opin Gastroenterol
January 2025
Assistant Professor of Neonatal-Perinatal Medicine, Department of Pediatrics, School of Medicine, Ayatollah Mousavi Hospital, Zanjan University of Medical Sciences, Zanjan, Iran.
Purpose Of Review: Whether low birth weight (LBW) and preterm delivery (PD) are associated with the risk of developing celiac disease (CD) in children remains unclear. This systematic review and meta-analysis aimed to evaluate the association between LBW and PD with CD development in children.
Recent Findings: We searched PubMed, Embase, Scopus, Web of Science, and Google Scholar databases based on the Mesh terms to find observational studies that investigated the association of LBW and PD with CD development in children up to July 18, 2024.
Alzheimers Dement
December 2024
Aga Khan University, Nairobi, Kenya.
Background: Population growth and an increase in the number of Africans who survive to old age puts them at a higher risk of developing neurodegenerative diseases such as dementia and Alzheimer's. Little research has been conducted on community knowledge and perceptions of dementia in rural settings in Kenya.
Method: Community health volunteers, healthcare workers (HCWs), chiefs and assistant chiefs (n = 35) participated in five focus group discussions, each comprising seven- eight people.
Alzheimers Dement
December 2024
Department of Clinical, Educational, and Health Psychology, Division of Psychology and Language Sciences, University College London, London, United Kingdom.
Background: Familial frontotemporal dementia is an autosomal dominant heritable form of frontotemporal dementia, a form of dementia characterised by changes in personality, behaviour and communication which typically onsets in mid-life. Children of an affected parent are at 50% risk of inheriting the responsible genetic mutation and developing frontotemporal dementia themselves. Individuals living at-risk have high psychological morbidity, for example they report struggling with guilt and anxiety about risk to themselves and their children, decisions about whether to get tested, uncertainty about onset of symptoms, and see their risk as a barrier in life.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
Jeonbuk Provincial Dementia Center, Jeonju, Korea, Republic of (South).
Background: Combined cognitive training and physical activity has been known to improve brain function. The purpose of this study is to investigate whether combined intervention affects the improvement of cognitive function in the community-dwelling elderly, and to determine if it improves physical function, such as motor speed and balance.
Method: The study was conducted among community-dwelling elderly aged 65 years.
Clin J Pain
January 2025
Department of Anesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.
Objectives: Chronic pain (CP) significantly impacts emotional and physical well-being and overall quality of life across diverse populations in the United States (U.S.).
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