The Need for Pediatric Transitional Care in Arizona

[Audio] The Need for Pediatric Transitional Care in Arizona Addressing the Gap in Care in Medically Fragile Children.

[Audio] As a society, we have made significant strides in enhancing children's health and well-being. However, much more work remains to ensure that all children receive the care they require to thrive. The journey from the hospital to home has gotten relatively little attention. This is a crucial aspect of the kid's and family's journey to overcome the dread of caring for their child at home. Physically fragile children may struggle even more with this transition since they may have complex medical needs that require specialized care. In Arizona, there is an absence of care for physically frail children when they transition from the hospital to home. This gap could have a negative impact on the health and well-being of these children. Stopping this gap is critical to ensuring that all children receive the care they require to thrive..

[Audio] Pediatric transitional care is designed to help children with complex medical needs transition from hospital settings to home or long-term care, bridging the gap between intensive hospital care and home-based care. Its purpose is to ensure continuity of care by managing medical and non-medical needs during the transition, focusing on preventing complications, reducing readmissions, and improving health outcomes. For example, a child reliant on a ventilator may face significant challenges transitioning home without adequate support and training, highlighting the critical role of pediatric transitional care in ensuring a safe and smooth process..

[Audio] Pediatric transitional care is essential for medically fragile children, particularly those with complex conditions such as cerebral palsy or heart defects, who require constant care. Disruptions in their care can lead to serious medical complications, which transitional care helps to prevent. Key components include comprehensive care plans that cover daily medical management, emergency protocols, and medications, as well as coordination among pediatricians, specialists, and home care teams. Family education is also critical, offering intensive training for parents and caregivers on using medical devices, administering medications, and handling emergencies. Additionally, access to necessary medical resources ensures that equipment and care are readily available in the home setting..

[Audio] This presentation highlights the need for pediatric transitional care in Arizona, where several challenges persist. These challenges include limited access to specialized facilities and the high costs associated with care. As a result, medically fragile children in Arizona struggle to receive the necessary support, making it difficult for them to transition smoothly from the hospital to home.

[Audio] Arizona's lack of facilities and support for pediatric transitional care has created significant challenges. The closure of Los Niños, the state's only pediatric subacute care facility, has left a gap in critical transitional support for medically fragile children. As a result, many families are now forced to take their children home without adequate medical or educational resources, leading to increased hospital readmissions, medical errors, and overwhelming caregiver stress. This shortage of transitional care options also strains hospitals, which must keep medically stable children longer than necessary, occupying critical care beds that could be used for other patients..

[Audio] High readmission rates are a significant issue for medically fragile children, with statistics showing that their readmission rates are 30-40% higher without proper transitional support. Many of these readmissions are preventable with adequate transitional care, such as training for caregivers and follow-up services. For example, a child discharged with a feeding tube may be readmitted due to improper handling by untrained parents, leading to infections or complications. Transitional care facilities can offer the necessary training and monitoring to reduce these preventable readmissions, improving overall outcomes for children and families..

[Audio] The financial performance of pediatric transitional care programs that I investigated yielded some astonishing outcomes. It has reduced the need for expensive hospitalizations and emergency department visits by giving families the tools to care for their medically fragile kid at home and assisting with care coordination. It reduces the level of anxiety that families experience when caring for a medically vulnerable child at home. By providing continuing assistance, resources, and understanding, parents/caregivers have been able to effectively manage their child's chronic diseases and avoid future costly hospitalizations. Overall, our pediatric transitional care program has been quite financially successful. It has reduced healthcare costs while improving patient health outcomes..

[Audio] The cost comparison between hospital care and transitional care highlights significant savings. In Arizona, pediatric hospital stays for high-acuity care range from $5000 to $8000 per day, with extended stays for medically fragile children often lasting weeks or months, greatly increasing overall costs. In contrast, pediatric transitional care facilities typically cost $1500 to $2500 per day, making them a more cost-effective alternative. For example, if a child spends a month in the hospital at $8000 per day, followed by a month in a transitional care facility at $2500 per day, the total costs are substantially reduced while still ensuring quality care.

[Audio] Reducing readmission costs through transitional care presents significant potential savings. Transitional care can lower readmissions by up to 60%, avoiding the expenses associated with additional hospital stays. Preventing just one hospital readmission can save up to $20000 per case. Over the long term, reducing readmissions also alleviates the financial strain on Arizona's Medicaid system. For example, avoiding readmissions for 100 children could result in annual savings of 10 million dollars, demonstrating the substantial economic and healthcare benefits of investing in transitional care..

[Audio] Pediatric transitional care can play a vital role in the healthcare of some medically fragile children and their families..

[Audio] Successful models in other states demonstrate the impact of pediatric transitional care. In California, implementing transitional care facilities resulted in a 50% reduction in hospital readmissions and 30 million dollars in annual Medicaid savings. For example, in urban centers like Los Angeles, these facilities have significantly lowered readmission rates and improved outcomes for children with complex medical conditions. Similarly, Illinois' Community Integration Program achieved a 60% reduction in readmissions by utilizing community-based transitional care, allowing children to live at home or in community settings with appropriate medical oversight. This program reduced hospital stays and improved the quality of life for medically fragile children..

[Audio] Lessons from California and Illinois highlight that pediatric transitional care significantly improves outcomes and saves money. These successful models demonstrate that similar approaches can be adapted to meet Arizona's unique needs, particularly given the growing population of medically fragile children in urban areas. Implementing such models in Arizona could help lower costs, reduce hospital burden, and enhance health outcomes for children affiliated with the Department of Developmental Disability..

[Audio] Proposal for Arizona. Proposal for Arizona.

[Audio] Policy recommendations for improving pediatric transitional care in Arizona include several key actions. First, dedicated pediatric transitional care facilities should be established to provide temporary, post-hospital care for medically fragile children. These facilities would focus on stabilizing children, training caregivers, and ensuring smooth transitions to home. Additionally, exploring funding opportunities is crucial, such as leveraging Medicaid waivers, applying for federal grants to enhance pediatric care infrastructure, and considering public-private partnerships to share costs and resources. Finally, collaboration with key stakeholders—including the Department of Developmental Disability, Arizona Health Care Cost Containment System, hospitals, and home care providers—is essential for developing and implementing effective transitional care programs. Creating a coalition will help ensure that care remains continuous and well-coordinated..

[Audio] The next steps for implementing pediatric transitional care involve several key actions. First, initiate a pilot program in urban centers like Phoenix or Tucson, where there is a high concentration of medically fragile children. This program should focus on collecting data related to cost savings, health outcomes, and caregiver satisfaction to assess its effectiveness before considering statewide expansion. Additionally, building a task force comprising healthcare providers, Medicaid officials, and community organizations is essential to ensure a unified approach to pediatric transitional care. Finally, secure funding by applying for federal grants and waivers to cover facility construction, staffing, and ongoing operations, and seek philanthropic support or private partnerships to supplement public funding..

[Audio] Medically fragile children in Arizona are at risk due to this lack, leading to high readmission rates, extended hospital stays, and financial strain on Medicaid. Pediatric transitional care provides a cost-effective, life-saving solution, improving health outcomes while reducing financial strain on Medicaid In summary, medically fragile children in Arizona face significant risks due to the lack of dedicated pediatric transitional care facilities. High readmission rates and extended hospital stays increase costs for families, hospitals, and the state. Pediatric transitional care offers a cost-effective, life-saving solution by improving health outcomes and reducing the financial strain on Medicaid, ultimately benefiting both the healthcare system and the families involved. Arizona must act swiftly to establish pediatric transitional care facilities, drawing on proven models from other states to enhance outcomes for medically fragile children and their families. Investing in this infrastructure will not only improve healthcare but also save millions in preventable costs, making it a crucial step for the well-being of both the children and the state's healthcare system.

[Audio] References. References. Pediatric Transitional Care Models and Success Stories • California Medicaid Reports on Transitional Care Savings: Review of Medical Therapy Program and Medi-Cal Managed Care. • Illinois Data on Pediatric Readmissions Post-Community Integration: Reduction of Hospital Readmissions through Effective Pediatric Transitional Care..

[Audio] References. Cost comparison Data. • Hospital Financial Reports for Pediatric Intensive Care: 2023 Pediatric Intensive Care Financial Analysis. • Pediatric Readmission Statistics: Factors Influencing Readmission Rates in Pediatric Populations. • Pediatric Readmission Data Report: National Trends..

[Audio] References. Arizona’s Medically Fragile Population.

[Audio] References. Mission of Medicaid Expansion and Policy Data.

[Audio] References. Current Gaps in Arizona’s Pediatric Transitional Care.