• J Hosp Med · Nov 2020

    Effect of Parental Adverse Childhood Experiences and Resilience on a Child's Healthcare Reutilization.

    • Anita N Shah, Katherine A Auger, Heidi J Sucharew, Colleen Mangeot, Kelsey Childress, Julianne Haney, Samir S Shah, Jeffrey M Simmons, Andrew F Beck, and Hospital-to-Homes Outcomes Trial Study Group.
    • Division of Hospital Medicine, Cincinnnati Children's Hospital Medical Center, Cincinnati, Ohio.
    • J Hosp Med. 2020 Nov 1; 15 (11): 645-651.

    BackgroundAdverse childhood experiences (ACEs) are associated with poor health outcomes in adults. Resilience may mitigate this effect. There is limited evidence regarding how parents' ACEs and resilience may be associated with their children's health outcomes.ObjectiveTo determine the association of parental ACEs and resilience with their child's risk of unanticipated healthcare reutilization.Design, Setting, And ParticipantsWe conducted a prospective cohort study (August 2015 to October 2016) at a tertiary, freestanding pediatric medical center in Cincinnati, Ohio. Eligible participants were English-speaking parents of children hospitalized on a Hospital Medicine or Complex Services team. A total of 1,320 parents of hospitalized children completed both the ACE questionnaire and the Brief Resilience Scale Survey.ExposureNumber of ACEs and Brief Resilience Scale Score among parents.Main OutcomesUnanticipated reutilization by children, defined as returning to the emergency room, urgent care, or being readmitted to the hospital within 30 days of hospital discharge.ResultsIn adjusted analyses, children of parents with 4 or more ACEs had 1.69-times higher odds (95% CI, 1.11-2.60) of unanticipated reutilization after an index hospitalization, compared with children of parents with no ACEs. Resilience was not significantly associated with reutilization.ConclusionParental history of ACEs is strongly associated with higher odds of their child having unanticipated healthcare reutilization after a hospital discharge, highlighting an intergenerational effect. Screening may be an important tool for outcome prediction and intervention guidance following pediatric hospitalization.

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