The Impact of COronaVIrus Disease of 2019 Pandemic on Home Health Nursing Availability in Pediatric Patients After Tracheostomy Placement.

IF 2.3 3区医学 Q1 PEDIATRICS

Pediatric Pulmonology Pub Date : 2025-09-01 DOI:10.1002/ppul.71273

Ferdinand Cacho, Katherine A Carr, Mariana Bedoya, Jacob A Kaslow

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引用次数: 0

Abstract

Background: Children with tracheostomies require skilled medical care performed by trained caregivers or home health nursing (HHN). HHN services are often limited, resulting in increased caregiver responsibilities. We aim to evaluate HHN availability, healthcare utilization, and mortality in tracheostomy dependent children, pre and post-COVID-19 pandemic.

Methods: Retrospective chart review of pediatric patients who underwent tracheostomy between November 2017 and September 2023. The COVID-19 pandemic time point was defined as March 15, 2020. Demographic, clinical and outcome parameters were collected from the electronic medical record. The pre- and postpandemic trend of HHN hours were evaluated using correlation statistics.

Results: Both groups had similar surrogate markers of medical complexity. There was no difference in the mean number of approved HHN hours, but both the mean number of HHN hours/week staffed (90 h vs. 50, p = 0.001) and mean percentage of approved HHN hours staffed (63% vs. 41%, p = 0.011) were significantly lower in the post-COVID-19 cohort. The trend in the pre-COVID-19 group was not statistically significant (ρ = 0.087, p = 0.639); the trend in the post-COVID-19 group was negative (ρ = -0.380, p = 0.001).

Conclusions: Since the COVID-19 pandemic, there has been a decrease in both the number and percentage of HHN hours staffed with no change in the number of approved HHN hours. Additionally, there was a decrease in hospital encounters in the post-COVID-19 group compared to pre-COVID-19. By assessing workforce shifts, medical providers, caregivers, and policymakers can appropriately anticipate the impact on this vulnerable population.

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2019年冠状病毒病大流行对小儿气管切开术后家庭健康护理可及性的影响

背景：气管切开术患儿需要由训练有素的护理人员或家庭健康护理（HHN）进行熟练的医疗护理。HHN服务往往是有限的，导致照顾者的责任增加。我们的目的是评估在covid -19大流行之前和之后气管切开术依赖儿童中HHN的可用性、医疗保健利用率和死亡率。方法：回顾性分析2017年11月至2023年9月间行气管切开术的儿科患者。新冠肺炎大流行的时间点被定义为2020年3月15日。从电子病历中收集人口学、临床和结局参数。采用相关统计方法评价HHN小时的流行前后趋势。结果：两组的医学复杂性替代指标相似。在covid -19后队列中，批准的平均HHN小时数没有差异，但平均HHN小时数/周（90小时对50小时，p = 0.001）和批准的HHN小时数的平均百分比（63%对41%，p = 0.011）均显著降低。在新冠肺炎前组，这一趋势无统计学意义（ρ = 0.087, p = 0.639）；后冠状病毒感染组呈阴性（ρ = -0.380, p = 0.001）。结论：自2019冠状病毒病大流行以来，HHN工作时数和百分比均有所下降，但批准的HHN工作时数没有变化。此外，与covid -19前相比，covid -19后组的医院就诊次数有所减少。通过评估劳动力转移，医疗服务提供者、护理人员和政策制定者可以适当地预测对这一弱势群体的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Pulmonology 医学-呼吸系统

CiteScore

6.00

自引率

12.90%

发文量

468

审稿时长

3-8 weeks

期刊介绍： Pediatric Pulmonology (PPUL) is the foremost global journal studying the respiratory system in disease and in health as it develops from intrauterine life though adolescence to adulthood. Combining explicit and informative analysis of clinical as well as basic scientific research, PPUL provides a look at the many facets of respiratory system disorders in infants and children, ranging from pathological anatomy, developmental issues, and pathophysiology to infectious disease, asthma, cystic fibrosis, and airborne toxins. Focused attention is given to the reporting of diagnostic and therapeutic methods for neonates, preschool children, and adolescents, the enduring effects of childhood respiratory diseases, and newly described infectious diseases. PPUL concentrates on subject matters of crucial interest to specialists preparing for the Pediatric Subspecialty Examinations in the United States and other countries. With its attentive coverage and extensive clinical data, this journal is a principle source for pediatricians in practice and in training and a must have for all pediatric pulmonologists.