A recent study by Michigan Medicine has found that many children who survive stays in pediatric intensive care units (PICUs) do not receive timely follow-up care with their primary physicians after discharge. The research, led by Erin Carlton, M.D., clinical associate professor in pediatric critical care at U-M Health, highlights a gap in post-hospitalization care for these patients.
"There aren't specific guidelines in terms of whether or when a child should follow up with their primary care physician or pediatrician after a stay in the PICU," said Carlton. This absence of clear recommendations prompted her and her colleagues to investigate the patterns of follow-up care among children aged 0-18 who had been hospitalized in the PICU.
The team analyzed insurance claims data from both private insurers and Medicaid to assess how many children saw their primary care provider within one week of leaving the ICU. Their findings showed that less than 25% of patients with public insurance and just under 30% with private insurance had such follow-up visits within a week. Additionally, about 9% of those with public insurance and around 10% with private insurance were seen by sub-specialists.
The study also noted that younger children and those without complex chronic conditions were more likely to have prompt primary care follow-up appointments.
"While many of us assumed that the majority of kids would be seen by their pediatrician within a week of discharge, that doesn't seem to be the case," Carlton stated.
Carlton's team is continuing research to determine how early follow-up visits may affect outcomes such as emergency department use and hospital readmissions. She emphasized the need for collaboration across different healthcare providers: "Within critical care, we're starting to more completely understand the long-term impact of critical illness. It's important to determine how we can partner with clinicians throughout the spectrum of healthcare, from the inpatient provider in the ICU to the child's pediatrician to try to ensure the best outcomes for children and their families," she added.
