TY - JOUR
T1 - Healthcare Burden and Resource Utilization after Pediatric Acute Respiratory Distress Syndrome
T2 - A Secondary Analysis of the Collaborative Pediatric Critical Care Research Network Acute Respiratory Distress Syndrome Study
AU - Ames, Stefanie G.
AU - Maddux, Aline B.
AU - Burgunder, Lauren
AU - Meeks, Huong
AU - Fink, Erica L.
AU - Meert, Kathleen L.
AU - Zinter, Matt S.
AU - Mourani, Peter M.
AU - Carcillo, Joseph A.
AU - Carpenter, Todd
AU - Pollack, Murray M.
AU - Mareboina, Manvita
AU - Notterman, Daniel A.
AU - Sapru, Anil
AU - Harding, Monica
AU - Nicklawsky, Andrew
AU - Coleman, Whit
AU - Bisping, Stephanie
AU - Sorenson, Sam
AU - Flick, Kristi
AU - Bracken, Caleb
AU - Pawluszka, Ann
AU - Lulic, Melanie
AU - Diliberto, Mary Ann
AU - Tomanio, Elyse
AU - Hession, Diane
AU - Patel, Neha
AU - Little, Mackenzie
AU - Barcikowski, Ashley
AU - Van, Kevin
AU - Ladell, Diane
AU - Grosskreuz, Ruth
AU - Steele, Lisa
AU - Flowers, Maggie
AU - Popelka, Jill
AU - Hensley, Josey
AU - Ratiu, Anna
AU - Deshmukh, Tanaya
AU - Ashtari, Neda
AU - McKenzie, Anne
AU - Chico, Denise Villarreal
AU - Zetino, Yensy
AU - Koch, Leighann
N1 - Publisher Copyright:
© 2024 Lippincott Williams and Wilkins. All rights reserved.
PY - 2024/6/1
Y1 - 2024/6/1
N2 - OBJECTIVES: To describe family healthcare burden and health resource utilization in pediatric survivors of acute respiratory distress syndrome (ARDS) at 3 and 9 months. DESIGN: Secondary analysis of a prospective multisite cohort study. SETTING: Eight academic PICUs in the United States (2019-2020). PATIENTS: Critically ill children with ARDS and follow-up survey data collected at 3 and/or 9 months after the event. INTERVENTIONS: None. METHODS AND MEASUREMENT: We evaluated family healthcare burden, a measure of healthcare provided by families at home, and child health resource use including medication use and emergency department (ED) and hospital readmissions during the initial 3-and 9-month post-ARDS using proxy-report. Using multivariable logistic regression, we evaluated patient characteristics associated with family healthcare burden at 3 months. MAIN RESULTS: Of 109 eligible patients, 74 (68%) and 63 patients (58%) had follow-up at 3-and 9-month post-ARDS. At 3 months, 46 families (62%) reported healthcare burden including (22%) with unmet care coordination needs. At 9 months, 33 families (52%) reported healthcare burden including 10 families (16%) with unmet care coordination needs. At month 3, 61 patients (82%) required prescription medications, 13 patients (18%) had ED visits and 16 patients (22%) required hospital readmission. At month 9, 41 patients (65%) required prescription medications, 19 patients (30%) had ED visits, and 16 (25%) required hospital readmission were reported. Medication use was associated with family healthcare burden at both 3 and 9 months. In a multivariable analysis, preillness functional status and chronic conditions were associated with healthcare burden at month 3 but illness characteristics were not. CONCLUSIONS: Pediatric ARDS survivors report high rates of healthcare burden and health resource utilization at 3-and 9-month post-ARDS. Future studies should assess the impact of improved care coordination to simplify care (e.g., medication management) and improve family burden.
AB - OBJECTIVES: To describe family healthcare burden and health resource utilization in pediatric survivors of acute respiratory distress syndrome (ARDS) at 3 and 9 months. DESIGN: Secondary analysis of a prospective multisite cohort study. SETTING: Eight academic PICUs in the United States (2019-2020). PATIENTS: Critically ill children with ARDS and follow-up survey data collected at 3 and/or 9 months after the event. INTERVENTIONS: None. METHODS AND MEASUREMENT: We evaluated family healthcare burden, a measure of healthcare provided by families at home, and child health resource use including medication use and emergency department (ED) and hospital readmissions during the initial 3-and 9-month post-ARDS using proxy-report. Using multivariable logistic regression, we evaluated patient characteristics associated with family healthcare burden at 3 months. MAIN RESULTS: Of 109 eligible patients, 74 (68%) and 63 patients (58%) had follow-up at 3-and 9-month post-ARDS. At 3 months, 46 families (62%) reported healthcare burden including (22%) with unmet care coordination needs. At 9 months, 33 families (52%) reported healthcare burden including 10 families (16%) with unmet care coordination needs. At month 3, 61 patients (82%) required prescription medications, 13 patients (18%) had ED visits and 16 patients (22%) required hospital readmission. At month 9, 41 patients (65%) required prescription medications, 19 patients (30%) had ED visits, and 16 (25%) required hospital readmission were reported. Medication use was associated with family healthcare burden at both 3 and 9 months. In a multivariable analysis, preillness functional status and chronic conditions were associated with healthcare burden at month 3 but illness characteristics were not. CONCLUSIONS: Pediatric ARDS survivors report high rates of healthcare burden and health resource utilization at 3-and 9-month post-ARDS. Future studies should assess the impact of improved care coordination to simplify care (e.g., medication management) and improve family burden.
KW - acute respiratory distress syndrome
KW - functional status
KW - patient-reported outcome measures
KW - pediatric intensive care unit
KW - quality of life
KW - survivors
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U2 - 10.1097/PCC.0000000000003476
DO - 10.1097/PCC.0000000000003476
M3 - Article
C2 - 38445974
AN - SCOPUS:85195327508
SN - 1529-7535
VL - 25
SP - 518
EP - 527
JO - Pediatric Critical Care Medicine
JF - Pediatric Critical Care Medicine
IS - 6
ER -