Factors influencing hospital admissions and emergency department visits among children with complex chronic conditions: a qualitative study of parents’ and providers’ perspectives
- 14 January 2014
- journal article
- Published by Taylor & Francis Ltd in Issues in Comprehensive Pediatric Nursing
- Vol. 37 (1), 61-80
- https://doi.org/10.3109/01460862.2013.855844
Abstract
Children with complex chronic conditions (CCC) have greater health care needs and use rates than children in general. Elevated health care use includes more frequent hospital admissions, longer hospital stays, and greater health care expenses. Prior studies have examined population characteristics associated with increased hospital admissions, emergency department (ED) use, and general healthcare use, yet few studies have investigated these events from the parents’ or health care providers’ point of view. The purpose of this study was to explore parents/caregivers’ and health care providers’ perceptions of the factors placing infants and young children with CCC at risk for or protecting them against hospital admissions and ED visits. Parents or primary caregivers participated in interviews, and health care providers in pediatric acute care, pediatric primary care, and emergency care participated in focus groups. Interview and focus group data were analyzed using directed content analysis and an ecological risk and protective factors model. The analysis revealed that parents/caregivers and health care providers described risk factors and protective factors on multiple ecological levels surrounding the child with CCC. This article presents these findings, which add to current knowledge of factors influencing hospital admissions and ED visits and may be used to inform interventions addressing high health care utilization in this population. This article concludes with the implications of the findings for future research and nursing practice.Keywords
This publication has 22 references indexed in Scilit:
- Nursing the patient with complex communication needs: time as a barrier and a facilitator to successful communication in hospitalJournal of Advanced Nursing, 2011
- Children With Complex Chronic Conditions in Inpatient Hospital Settings in the United StatesPEDIATRICS, 2010
- Increasing Prevalence of Medically Complex Children in US HospitalsPEDIATRICS, 2010
- Paediatric frequent attenders at emergency departments: A linked-data population studyJournal of Paediatrics and Child Health, 2010
- NAPNAP Position Statement on Pediatric Health Care/Medical Home: Key Issues on Delivery, Reimbursement, and LeadershipJournal of Pediatric Health Care, 2009
- Children with chronic conditions in a paediatric emergency departmentActa Paediatrica, 2006
- Three Approaches to Qualitative Content AnalysisQualitative Health Research, 2005
- Translating Social Ecological Theory into Guidelines for Community Health PromotionAmerican Journal of Health Promotion, 1996
- Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: Implications for substance abuse prevention.Psychological Bulletin, 1992
- Hazardous Secrets and Reluctantly Taking Charge: Parenting a Child with Repeated HospitalizationsImage: the Journal of Nursing Scholarship, 1991