• Alicia G Kachmar, R Scott Watson, David Wypij, Mallory A Perry, CurleyMartha A QMAQDepartment of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA.Department of Critical Care and Anesthesia, The Children's Hospital of Philadelphia Research Institute, Philadelphia, PA.Departme, and for the Randomized Evaluation of Sedation Titration for Respiratory Failure ( RESTORE ) Investigative Team.
• Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, PA.
• Crit. Care Med. 2022 Feb 1; 50 (2): e117e128e117-e128.

ObjectivesSocioeconomic factors may impact healthcare resource use and health-related quality of life, but their association with postcritical illness outcomes is unknown. This study examines the associations between socioeconomic status, resource use, and health-related quality of life in a cohort of children recovering from acute respiratory failure.DesignSecondary analysis of data from the Randomized Evaluation of Sedation Titration for Respiratory Failure clinical trial.SettingThirty-one PICUs.PatientsChildren with acute respiratory failure enrolled whose parent/guardians consented for follow-up.Measurements And Main ResultsResource use included in-home care, number of healthcare providers, prescribed medications, home medical equipment, emergency department visits, and hospital readmission. Socioeconomic status was estimated by matching residential address to census tract-based median income. Health-related quality of life was measured using age-based parent-report instruments. Resource use interviews with matched census tract data (n = 958) and health-related quality of life questionnaires (n = 750/958) were assessed. Compared with high-income children, low-income children received care from fewer types of healthcare providers (β = -0.4; p = 0.004), used less newly prescribed medical equipment (odds ratio = 0.4; p < 0.001), and had more emergency department visits (43% vs 33%; p = 0.04). In the youngest cohort (< 2 yr old), low-income children had lower quality of life scores from physical ability (-8.6 points; p = 0.01) and bodily pain/discomfort (+8.2 points; p < 0.05). In addition, health-related quality of life was lower in those who had more healthcare providers and prescribed medications. In older children, health-related quality of life was lower if they had prescribed medications, emergency department visits, or hospital readmission.ConclusionsChildren recovering from acute respiratory failure have ongoing healthcare resource use. Yet, lower income children use less in-home and outpatient services and use more hospital resources. Continued follow-up care, especially in lower income children, may help identify those in need of ongoing healthcare resources and those at-risk for decreased health-related quality of life.Copyright © 2021 by the Society of Critical Care Medicine and Wolters Kluwer Health, Inc. All Rights Reserved.

21 keywords...

hide…