Seeing a GP within a week of PICU discharge linked to fewer returns

Design

Matched retrospective cohort, US insurance claims

Population

180,516 paediatric intensive care hospitalisations, 2016–2019

Primary outcome

Days of emergency or hospital use, days 8–90 after discharge

Effect

IRR 0.93 (95% CI 0.90–0.96) public insurance; 0.70 (0.63–0.77) private insurance

Using US insurance claims from 2016 to 2019, investigators matched 180,516 paediatric intensive care stays one to one on demographic and clinical characteristics, comparing children seen in primary care within seven days of discharge with those who were not. The outcome was days of emergency department use or readmission from day 8 to day 90.

Acute care use after discharge was common — about one in three publicly insured children. Early follow-up was associated with fewer acute care days in both publicly insured children (IRR 0.93) and privately insured children (IRR 0.70). The association was larger in older children and after sepsis, and it persisted in data from 2022–23.

Children leaving intensive care often have new medicines, new equipment and anxious parents. An early review gives a chance to catch problems before they become an emergency attendance.

This is observational: families who attend early may differ in ways claims cannot capture. But the intervention — a booked appointment — is cheap and low-risk, and the size of the population makes the signal hard to ignore.

• Book a primary care or paediatric review within seven days for every child discharged after intensive care.
• Send a discharge summary to the family doctor before that visit, listing new medicines and red flags.
• Give parents clear written warning signs and a direct contact number.
• Prioritise early review for older children and those recovering from sepsis.

Why it matters

The days after PICU discharge are a high-risk gap that a simple appointment may help close.

Don't overread it

This was observational; it cannot prove that the visit itself prevented readmissions.

The statistics, in plain English

An incidence rate ratio of 0.93 means about 7% fewer acute care days in publicly insured children; 0.70 means about 30% fewer in privately insured children. Matching reduces but cannot remove differences between families who did and did not attend.

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