Project Summary
This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
Before a child goes home after a hospital stay, doctors often advise parents to schedule a follow-up visit with their child’s primary care doctor. Follow-up visits can help families and patients get the care they need and avoid going back to the hospital. But going to follow-up visits can also be a burden for families.
In this study, the research team is comparing automatic to as-needed follow-up care for children after a hospital stay. In automatic follow-up, doctors advise parents to schedule a follow-up visit within one week after leaving the hospital, even if their child’s symptoms improve or resolve. In as-needed follow-up, doctors tell parents to schedule a follow-up visit only if their child’s health doesn’t improve or gets worse.
The team wants to know how well each way helps children avoid going back to the hospital and improves outcomes for families.
Who can this research help?
Results may help healthcare teams when considering ways to suggest that parents set up follow-up visits after their child’s hospital stay.
What is the research team doing?
The research team is recruiting children from hospitals across the United States. Children are receiving care for common infections such as pneumonia. The team is assigning children by chance to receive automatic or as-needed follow-up. The team is surveying parents one month after leaving the hospital to learn if the child:
- Went back to the hospital within 14 days
- Received medical care from a clinician other than their primary care doctor
- Received a lab test or started taking a new medicine
- Missed school
The research team is also surveying parents to learn about their quality of life, their relationship with their child’s primary care doctor, and if the child is up to date with vaccines. Also, the team is surveying and talking with parents and clinicians to learn about their experiences with as-needed follow-up care. Finally, the team wants to know if factors such as the patient’s race and income affect how well the two kinds of follow-up work for families.
The team is using findings from the study to develop guidance on how best to use the as-needed follow-up approach.
Parents, doctors, hospital administrators, and health insurers are helping to plan and conduct this study.
Research methods at a glance
| Design Element | Description |
|---|---|
| Design | Randomized controlled trial |
| Population | 2,674 children 18 years of age and younger who were hospitalized due to a primary diagnosis of pneumonia, skin and soft tissue infection, acute gastroenteritis, or urinary tract infection and a parent who speaks English or Spanish |
| Interventions/ Comparators |
|
| Outcomes |
Primary: hospital readmission Secondary: medical intervention (laboratory test, imaging test, or a new medicine), parent-reported child health-related quality of life, number of missed school hours for children, number of missed work hours for parents, parent relationship with primary care provider, child immunizations, total cost to parents related to child’s illness, symptom duration, ambulatory care visits (clinic, urgent care, emergency department), parent self-efficacy, parent anxiety, satisfaction with care, telephone and electronic communications with medical providers, well-child visits, proportion of participants who report having a usual place of medical care, medical errors |
| Timeframe | 2-week follow-up for primary outcome |
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*Increase Diversity and Advance Health Equity Funding Supplement |