FACTORS INFLUENCING HOSPITAL ADMISSIONS AND EMERGENCY DEPARTMENT VISITS AMONG CHILDREN WITH COMPLEX CHRONIC CONDITIONS: A QUALITATIVE STUDY OF PARENTS' AND PROVIDERS' PERSPECTIVES
FACTORS INFLUENCING HOSPITAL ADMISSIONS AND EMERGENCY DEPARTMENT VISITS AMONG CHILDREN WITH COMPLEX CHRONIC CONDITIONS: A QUALITATIVE STUDY OF PARENTS' AND PROVIDERS' PERSPECTIVES
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DOI：
10.3109/01460862.2013.855844
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发表时间：
2014-01-01
影响因子：
2.1
通讯作者：
Laken, Marilyn A.
中科院分区：
文献类型：
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作者：
Hudson, Shannon M.;Newman, Susan D.;Laken, Marilyn A.
患有复杂慢性病（CCC）的儿童比一般儿童有更大的卫生保健需求和使用率。医疗保健使用的增加包括更频繁的住院，更长的住院时间和更高的医疗保健费用。先前的研究已经检查了与增加的入院率、急诊科（艾德）使用和一般医疗保健使用相关的人群特征，但很少有研究从父母或医疗保健提供者的角度调查这些事件。本研究的目的是探讨父母/照顾者和卫生保健提供者的看法的因素，使婴幼儿CCC的风险或保护他们免受入院和艾德访问。父母或主要照顾者参与了访谈，儿科急症护理、儿科初级护理和急诊护理的卫生保健提供者参与了焦点小组。访谈和焦点小组的数据进行了分析，使用定向内容分析和生态风险和保护因素模型。分析显示，父母/照顾者和卫生保健提供者描述的风险因素和保护因素在多个生态水平周围的儿童与CCC。本文介绍了这些研究结果，增加了目前的知识，影响住院和艾德访问的因素，并可用于告知干预措施，解决高卫生保健利用在这一人群。本文最后提出研究结果对未来研究及护理实务之意涵。
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.