43 Far from Home: The Impact of Geographic Distance from Tertiary Paediatric Hospitals on Family Expenses and Experiences
Notice bibliographique
Résumé
Abstract Background Many individuals living in rural and remote communities are required to travel to urban centres to receive essential health care. These experiences may be especially complex for children and their families. Despite this, there is a lack of available literature on the experiences of children and families travelling to receive care at tertiary paediatric hospitals in Canada, specifically regarding associated costs and psychosocial impacts. 1.Objectives: Analyze tertiary hospital-based administrative data to quantify the number of admissions and length-of-stay for families living > 50 km from the hospital. 2.Describe the costs and psychosocial impacts of hospitalization on families living > 50 km from the hospital. Design/Methods Ethics approval was obtained. Family partners were involved in all aspects of the study design. We obtained a de-identified data set describing the length of stay and home community of paediatric patients admitted to our paediatrics unit. Descriptive statistics were produced to determine the relevant study population and inform subsequent data analyses. A cross-sectional survey was distributed to interested caregivers admitted to our paediatrics team. Participants were offered a $20 gift card as remuneration. The survey included optional questions to assess participant demographics, costs associated with hospitalization, and subjective stress levels. Descriptive statistics were reported. Results Administrative data analysis described 2,758 admissions to a paediatric tertiary hospital from January 1, 2021 to December 31, 2021. Patients from rural and remote communities were 9.54% of total admissions. Regression models found a strong statistical relationship between length of stay and distance from the tertiary centre (Pearson chi2 coefficient 58.9, p < 0.001). A total of 39 caregivers filled out the cross-sectional survey. 75% (n=29) of participants were from local communities and 25% (n=10) were from rural and remote communities. 82% (n=32) of hospital stays were unplanned. 54% (n=21) of participants paid out-of-pocket transportation costs and 13% (n=5) paid out-of-pocket accommodation costs. 82% (n=32) of participants had co-travellers. 20% (n=8) of participants reported difficulty paying for hospital-associated costs and 10% (n=4) had to borrow money to do so. Conclusion To our knowledge, this study is the first to look at the psychological and socioeconomic barriers facing families travelling to a tertiary paediatric hospital in Canada. Patients from outside the local area had increased odds of longer length of stay and participants described a variety of stressors associated with hospitalization. We hope to translate this data into evidence-based interventions to better support these families.
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Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,009 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,003 | 0,002 |
| Communication savante | 0,003 | 0,001 |
| Science ouverte | 0,001 | 0,004 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,004 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
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