Pediatric Home Health Market Validation

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7041550/ (Readmission)

    • Parents identified multiple challenges associated with chronicity of medical management and transitions of care for CMC. Future interventions aiming to improve continuity and communication between admissions, ensure that home services are provided when applicable and prescriptions are filled, and provide comprehensive support for families in both the short- and long-term may help improve patient and family experiences while potentially decreasing readmissions.


  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290238/ (Delayed Discharge)

    • 54% had discharge delays, the majority were primarily due to lack of home nursing (62%), followed by delay of caregiver training (18%), caregiver health and social issues (8%), and delay in a transitional care facility bed (8%). Of the 39 delayed patients, 10% ($13 217 889) of hospital charges occurred during excess days with a median of $186 061 (IQR $117 661–$386 905) per patient.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5976226/ (Nursing Shortage)

    • The demand for nurses to care for the aging baby-boomer generation is great, with the demand greater still for qualified, trained pediatric nurses able to care for children with complex medical needs in the home setting. The staff shortage is worse in pediatric home health nursing work than all other nursing fields, particularly when considering the training expertise, comfort with care complexity, and scope of practice required for nurses caring for children in the home setting….Families reported multiple delays to hospital discharges (mean, 15 days per delay) due to inability to find home nursing coverage. Respiratory technology and lack of Medicaid coverage (P < .02) correlated with the gap in home nursing access.

    • In order to find nurses to staff their child's care at home, it is required that multiple home health company nurses and private-duty nurses work with the same child in order to achieve coverage for the child's needs during the day and night hours. Families tend to have an average of 3 home health nurses (range, 0-10) and 3 private-duty nurses (range, 0-8) working in their home every month to piece together coverage for their child.

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7290239/ (Readmission)

    • They described that lack of home nursing was one of the primary drivers of readmissions due to parental exhaustion and lack of medical expertize in the home….Improved incentives for the home health workforce to increase manpower would be ultimately offset by reduced hospitalizations for children with MTD.

    • While care coordinators did not report specific incidences of clear insufficient parental preparation for homecare, the trend of readmissions either shortly after discharge due to family preparedness or generally trending toward younger children/parents new to home care suggests missed opportunities to optimize training for families and community health providers. Perhaps universal application of simulation lab training would better prepare families to respond in these emergent situations.29,30 Likewise, home health nurses may also benefit from access to simulation training, which in pediatric training has the capacity to familiarize learners to rare events.31,32

  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199441/ (Quality of Pediatric Home Care)

    • As a result, families with insurance-approved service hours reported gaps in home healthcare, particularly at night, and hospitalized patients experienced delays in discharge. Provider turnover led families to re-train providers and/or to work with multiple home healthcare agencies to cover the needed shifts…On the job training of private duty nursing by caregivers was described as routine. Interviewees had safety concerns regarding the level of private duty nursing training, especially for CMC with tracheostomies and/or mechanical ventilation, and noted the need to balance a safe hospital discharge with adequate home healthcare coverage. Concerns regarding the quality of community airway safety training led to a multidisciplinary hospital initiative to provide education outreach.