Pediatric critical care survivors often lack prompt primary care follow up

When the unthinkable happens and a child is left critically ill or injured, the miracle workers in pediatric intensive care units around the country work tirelessly to save their lives.

Yet, after discharge from the hospital, many of these children could be missing out on vital follow up care, finds a study from Michigan Medicine.

"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 Erin Carlton, M.D., clinical associate professor in pediatric critical care at U-M Health.

It was this lack of guidance that drove her and her collaborators to look more closely at what happens with this group of patients after hospitalization.

Using data from both private insurance and Medicaid claims, they examined rates of follow up care within the one week of ICU discharge for patients aged 0-18.

They discovered that just under 25% of patients with public insurance and just under 30% of patients with private insurance had primary care follow up within one week of PICU hospitalization.

About 9% with public insurance and about 10% with private insurance were seen by a sub-specialist.

Kids who were younger and who did not have existing complex chronic conditions were more likely to receive timely follow up care from a primary care clinician.

"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," said Carlton.

Her team has an ongoing follow up study to look at the impact of having that early follow up with subsequent outcomes, including emergency department use and hospital readmissions, she notes.

"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.