OBJECTIVE Pediatric inpatient care has become increasingly regionalized and dependent on large children’s hospitals, causing pediatric patients to travel further distances for inpatient care. Our objective was to describe the characteristics and outcomes of patients admitted by pediatric telehospitalists to the pediatric units of 2 community hospitals. METHODS This was a multicenter retrospective cohort study among pediatric patients admitted via telehospitalist at 2 community hospitals over a 3-month period. Descriptive data collected included demographics for each patient, length of stay, discharge disposition, safety events, and reutilization. RESULTS Seventy-four patients were admitted by telehospitalist providers during the study period. Median (IQR) age was 3.5 (1.0, 12.8) years. Median (IQR) length of stay was 1 (1, 2) day. The most common diagnoses for admitted patients were bronchiolitis (23%), asthma (15%), suicidal ideation (12%), and seizure activity (7%). Sixty-five (88%) patients were discharged home, and seven (9%) were discharged to a psychiatric facility. Two (3%) patients were transferred to a higher level of care. Four (5%) patients returned to the emergency department within 30 days, and one (1%) was readmitted. Fourteen (19%) patients had complex chronic conditions, which were most commonly neuromuscular/neurological, metabolic, and neonatal conditions. CONCLUSIONS Children admitted by telehospitalist comprised a variety of diagnoses, and nearly 1 in 5 had at least 1 complex chronic condition. Patients admitted by telehospitalist had reasonable rates of care escalation and reutilization, suggesting that this may be a feasible option for community hospital nighttime coverage.
Meurs et al. (Mon,) studied this question.