A primary care visit within a week of PICU discharge was associated with fewer return visits

Design

Matched retrospective cohort using insurance claims

Population

180,516 US PICU hospitalisations, 2016 to 2019

Primary outcome

Days of emergency department or hospital use from day 8 to day 90 after discharge

Effect

IRR 0.93 (0.90 to 0.96) public insurance; IRR 0.70 (0.63 to 0.77) private insurance

Using claims data, researchers matched children who had a primary care visit within seven days of PICU discharge with similar children who did not, and compared emergency and hospital use over the following three months.

Early follow-up was associated with less acute care use, modestly in publicly insured children and substantially in privately insured children. The association held in a later dataset from 2022 to 2023.

The study cannot rule out that families who attend early are different in other ways. Still, an early visit is low-cost and gives a chance to review medicines, feeding and recovery.

• Acute care use within 8 to 90 days followed 35% of publicly insured and 24% of privately insured PICU stays.
• Early follow-up was associated with 7% fewer acute care days in public insurance and 30% fewer in private.
• The association was stronger after sepsis and in older children.
• Send a discharge summary the family can carry to the first visit.

Why it matters

About one in three publicly insured children returned to acute care within three months of PICU discharge, and early follow-up is a simple step to target.

Don't overread it

This is an observational claims analysis; families who attend early follow-up may differ in ways matching cannot capture.

The statistics, in plain English

An incidence rate ratio of 0.93 means 7% fewer days of acute care; 0.70 means 30% fewer. Both intervals exclude 1.

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