Home Health Nursing Agencies’ Services for Children With Medical Complexity: Parent and Nurse Perspectives

Sobotka, Sarah A.; Lynch, Emma; Golden, Shannon L.S.; Nageswaran, Savithri

doi:10.1016/j.acap.2024.01.015

Cited by 1 publication

(1 citation statement)

References 30 publications

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“…Family training at the bedside during hospitalizations has also effectively reduced caregiver distress and improved home-based support in previous research [ 19 ]. Further, existing research cites the variability in agencies’ hiring and training practices as a limitation for home health nurses, contributing to issues with retention and long-term support of families of CMC [ 49 ]. Paired with training and certification opportunities for caregivers and home nurses in patient-specific care needs, this proposed intervention may mediate the financial and household-level burden on caregivers of CMC for those with and without accessible home nursing care alike.…”

Section: Discussionmentioning

confidence: 99%

Bridging the gaps in pediatric complex healthcare: the case for home nursing care among children with medical complexity

Koob,

Griffin,

Stuenkel

et al. 2024

BMC Health Serv Res

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Background Children with medical complexity (CMC) comprise < 1% of the pediatric population, but account for nearly one-third of healthcare expenditures. Further, while CMC account for up to 80% of pediatric inpatient hospital costs, only 2% of Medicaid spending is attributed to home healthcare. As a result, the current health system heavily relies on family caregivers to fill existing care gaps. This study aimed to: (1) examine factors associated with hospital admissions among CMC and (2) contextualize the potential for home nursing care to improve outcomes among CMC and their families in South Carolina (SC). Methods This mixed-methods study was conducted among CMC, their family caregivers, and physicians in SC. Electronic health records data from a primary care clinic within a large health system (7/1/2022-6/30/2023) was analyzed. Logistic regression examined factors associated with hospitalizations among CMC. In-depth interviews (N = 15) were conducted among physicians and caregivers of CMC statewide. Patient-level quantitative data is triangulated with conceptual findings from interviews. Results Overall, 39.87% of CMC experienced ≥ 1 hospitalization in the past 12 months. CMC with higher hospitalization risk were dependent on respiratory or neurological/neuromuscular medical devices, not non-Hispanic White, and demonstrated higher healthcare utilization. Interview findings contextualized efforts to reduce hospitalizations, and suggested adaptations related to capacity and willingness to provide complex care for CMC and their families. Conclusions Findings may inform multi-level solutions for accessible, high-quality home nursing care among CMC and their families. Providers may learn from caregivers’ insight to emphasize family-centered care practices, acknowledging time and financial constraints while optimizing the quality of medical care provided in the home.

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Section: Discussionmentioning

confidence: 99%