Home nursing after hospitalization helps medically complex children get needed care in a safe environment. A reports looks at how variable it can be in different states.
For children who are medically complex, home nursing is key to helping them get needed care in a familiar environment. A report from Pediatrics looks at variability in posthospitalization home nursing.1
The investigators ran a retrospective cohort study of children aged 0 to 18 years who had ≥ 1 complex chronic condition and had been hospitalized. The children had been covered by commercial health insurance. Data came from the Truven MarketScan database. Primary outcome measures were whether the child received any home nursing in the 30 days after hospital discharge as well as how many days of home nursing occurred during the initial 30-day period.
They found that 9.9% of the sample were given home nursing. Following adjustment for patient characteristics, the likelihood of being given home nursing differed across the country, ranging from 3.4% to 19.2%. In the subset of children who were given home nursing, adjusted median home nursing days ranged from 6.6 days to 24.5 days across the country. The researchers concluded that there was significant variability between states for both getting home nursing care as well as the average number of days of home nursing care after hospitalization. They believe that state-level improvement plans could lead to significant overall improvements.
1. Rasooly IR, Shults J, Guevara JP, Feudtner C. State variation in posthospital home nursing for commercially insured medically complex children. Pediatrics. 2020:146(1):e20192465. doi:10.1542/peds.2019-2465