Study finds few children get timely follow-up care after critical illness

There are no guidelines for follow-up care after pediatric intensive care unit (PICU) hospitalization. To address this gap, a Michigan Medicine-led research team looked at how often children are seen by a pediatrician or primary care physician within one week of hospital discharge.

The study, published by CHEST, found that only one third of more than 375,000 children discharged after critical illness had primary care follow-up within discharge. Approximately 10 percent had specialty care follow-up within one week of discharge. Younger children and children with chronic conditions were more likely to have timely follow-up.

"In critical care there has been increasing recognition and focus on survivorship. Ongoing challenges after critical illness are increasingly recognized. Going forward, it is paramount to better support children and families after their critical illness," said study lead Erin F. Carlton, MD MSc, the associate director of the Child Health Evaluation and Research (CHEAR) Center fellowship programs.

"One of the things our team recognized is that there is little to no guidance on when, where, and with whom a child should follow up with after critical illness.  We wanted to understand was how often children are seen by a pediatrician or primary care physician within a week of discharge."

Additional analysis explored follow-up over a longer time period. “As expected, there's an increase in the proportion of children that were seen when looking over a longer time horizon, but still less than half were seen by 30 days, suggesting a large gap in continuity of care” she said. 

According to Carlton, next steps include determining whether children who received follow-up care had better clinical outcomes.