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Follow-Up Care Adherence After Hospital Discharge in Children With Traumatic Brain Injury

Spaw, Alexandra J ; Lundine, Jennifer P ; Johnson, Sarah A ; Peng, Jin ; Wheeler, Krista K ; Shi, Junxin ; Yang, Ginger ; Haley, Kathy J ; Groner, Jonathan I ; Xiang, Henry

The Journal of head trauma rehabilitation, 2018, Vol.33(3), pp.E1-E10 [Peer Reviewed Journal]

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  • Title:
    Follow-Up Care Adherence After Hospital Discharge in Children With Traumatic Brain Injury
  • Author: Spaw, Alexandra J ; Lundine, Jennifer P ; Johnson, Sarah A ; Peng, Jin ; Wheeler, Krista K ; Shi, Junxin ; Yang, Ginger ; Haley, Kathy J ; Groner, Jonathan I ; Xiang, Henry
  • Description: To investigate factors associated with follow-up care adherence in children hospitalized because of traumatic brain injury (TBI). An urban level 1 children's hospital trauma registry was queried to identify patients (2-18 years) hospitalized with a TBI in 2013 to 2014. Chart reviewers assessed discharge summaries and follow-up instructions in 4 departments. Three levels of adherence-nonadherence, partial adherence, and full adherence-and their associations with care delivery, patient, and injury factors. In our population, 80% were instructed to follow up within the hospital network. These children were older and had more severe TBIs than those without follow-up instructions and those referred to outside providers. Of the 352 eligible patients, 19.9% were nonadherent, 27.3% were partially adherent, and 52.8% were fully adherent. Those recommended to follow up with more than 1 department had higher odds of partial adherence over nonadherence (adjusted odds ratio [AOR] = 5.8, 95% CI: 1.9-17.9); however, these patients were less likely to be fully adherent (AOR = 0.1; 95% CI: 0.1-0.3). Privately insured patients had a higher AOR of full adherence. Nearly 20% of children hospitalized for TBI never returned for outpatient follow-up and 27% missed appointments. Care providers need to educate families, coordinate service provision, and promote long-term monitoring.
  • Is Part Of: The Journal of head trauma rehabilitation, 2018, Vol.33(3), pp.E1-E10
  • Identifier: E-ISSN: 1550-509X ; PMID: 28520664 Version:1 ; DOI: 10.1097/HTR.0000000000000314
  • Subjects: Registries ; Aftercare -- Standards ; Brain Injuries, Traumatic -- Epidemiology ; Patient Compliance -- Statistics & Numerical Data
  • Language: English

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