Article: Shah AN, Auger KA, Sucharew HJ, et al. Effect of Parental Adverse Childhood Experiences and Resilience on a Child's Healthcare Reutilization. J Hosp Med. 2020;15(11):645-651. doi:10.12788/jhm.3396.
Fellow: Kristyn Jeffries, MD; Children’s Mercy Kansas City
Summary: Adverse childhood experiences (ACEs) of adults have been associated with poor health outcomes, and parental ACEs have been correlated with their children’s adversity. Further, the hospitalization of a child can be acutely stressful for families with underlying chronic stress. This study intended to evaluate whether parental ACEs were associated with unanticipated healthcare reutilization by children with recent hospital discharge. The authors determined children of parents with a high number of ACEs (>4) had 1.69-times (95% CI, 1.11-2.60) higher odds of healthcare reutilization within 30 days of discharge compared to children of parents with no ACEs, after adjusting for covariates. Reported resilience of parents was not significantly associated with hospital reutilization.
Strengths: This prospective cohort study used administrative data about hospital utilization. The parental ACEs survey had a high response rate (74%), and a large number of parents (n=1320) were included in the study. The authors adjusted for important covariates, such as parental education, in their analysis.
Limitations: This study was performed at a single academic hospital with only English-speaking parents, limiting its generalizability to other populations.
Major Takeaway: Adversity experienced by parents may be a risk factor for their children’s unanticipated healthcare reutilization in the setting of a stressful hospitalization.
How this article should impact our practice: To improve child health outcomes, clinicians must be aware of chronic stress experienced by families as well as underlying social determinants of health. By providing trauma-informed care within the inpatient setting, pediatric hospitalists may be able to reduce the stress of hospitalizations and help these families develop positive coping skills to improve childhood health after discharge.
Fellow: Kristyn Jeffries, MD; Children’s Mercy Kansas City
Summary: Adverse childhood experiences (ACEs) of adults have been associated with poor health outcomes, and parental ACEs have been correlated with their children’s adversity. Further, the hospitalization of a child can be acutely stressful for families with underlying chronic stress. This study intended to evaluate whether parental ACEs were associated with unanticipated healthcare reutilization by children with recent hospital discharge. The authors determined children of parents with a high number of ACEs (>4) had 1.69-times (95% CI, 1.11-2.60) higher odds of healthcare reutilization within 30 days of discharge compared to children of parents with no ACEs, after adjusting for covariates. Reported resilience of parents was not significantly associated with hospital reutilization.
Strengths: This prospective cohort study used administrative data about hospital utilization. The parental ACEs survey had a high response rate (74%), and a large number of parents (n=1320) were included in the study. The authors adjusted for important covariates, such as parental education, in their analysis.
Limitations: This study was performed at a single academic hospital with only English-speaking parents, limiting its generalizability to other populations.
Major Takeaway: Adversity experienced by parents may be a risk factor for their children’s unanticipated healthcare reutilization in the setting of a stressful hospitalization.
How this article should impact our practice: To improve child health outcomes, clinicians must be aware of chronic stress experienced by families as well as underlying social determinants of health. By providing trauma-informed care within the inpatient setting, pediatric hospitalists may be able to reduce the stress of hospitalizations and help these families develop positive coping skills to improve childhood health after discharge.