Association of Socioeconomic Status With Postdischarge Pediatric Resource Use and Quality of Life.
Crit Care Med
; 50(2): e117-e128, 2022 02 01.
Article
em En
| MEDLINE
| ID: mdl-34495879
ABSTRACT
OBJECTIVES:
Socioeconomic factors may impact healthcare resource use and health-related quality of life, but their association with postcritical illness outcomes is unknown. This study examines the associations between socioeconomic status, resource use, and health-related quality of life in a cohort of children recovering from acute respiratory failure.DESIGN:
Secondary analysis of data from the Randomized Evaluation of Sedation Titration for Respiratory Failure clinical trial.SETTING:
Thirty-one PICUs. PATIENTS Children with acute respiratory failure enrolled whose parent/guardians consented for follow-up. MEASUREMENTS AND MAINRESULTS:
Resource use included in-home care, number of healthcare providers, prescribed medications, home medical equipment, emergency department visits, and hospital readmission. Socioeconomic status was estimated by matching residential address to census tract-based median income. Health-related quality of life was measured using age-based parent-report instruments. Resource use interviews with matched census tract data (n = 958) and health-related quality of life questionnaires (n = 750/958) were assessed. Compared with high-income children, low-income children received care from fewer types of healthcare providers (ß = -0.4; p = 0.004), used less newly prescribed medical equipment (odds ratio = 0.4; p < 0.001), and had more emergency department visits (43% vs 33%; p = 0.04). In the youngest cohort (< 2 yr old), low-income children had lower quality of life scores from physical ability (-8.6 points; p = 0.01) and bodily pain/discomfort (+8.2 points; p < 0.05). In addition, health-related quality of life was lower in those who had more healthcare providers and prescribed medications. In older children, health-related quality of life was lower if they had prescribed medications, emergency department visits, or hospital readmission.CONCLUSIONS:
Children recovering from acute respiratory failure have ongoing healthcare resource use. Yet, lower income children use less in-home and outpatient services and use more hospital resources. Continued follow-up care, especially in lower income children, may help identify those in need of ongoing healthcare resources and those at-risk for decreased health-related quality of life.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Qualidade de Vida
/
Classe Social
/
Aceitação pelo Paciente de Cuidados de Saúde
/
Recursos em Saúde
Tipo de estudo:
Clinical_trials
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limite:
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Idioma:
En
Revista:
Crit Care Med
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Panamá