Regionalization of Pediatric Care and the Role It Has on Recovery: A Single-Center Study

Monday, March 23, 2026

10:15 AM - 11:15 AM Central Time

Location: Connections Central - RST 09

Blythe E. Pollack, MSN, CPNP-AC

null
C.S. Mott Children’s Hospital, University of Michigan, Ann Arbor, Michigan

Disclosure(s): No relevant financial relationship(s) to disclose.
SG

Stephen Gorga, MD

Clinical Assistant Professor
University of Michigan CS Mott Children's Hospital

Disclosure information not submitted.
JK

Joseph Kohne, MD

Clinical Associate Professor of Pediatrics
University of Michigan CS Mott Children's Hospital, Michigan

Disclosure information not submitted.
TW

Taylor Whittington, MPH

Research Health Science Specialist
Veterans Affairs Center for Clinical Management Research, Ann Arbor, Michigan, Michigan

Disclosure information not submitted.
LY

Lauren Yoder, BS

Research Coordinator
Univerity of Michigan

Disclosure information not submitted.
Ryan Barbaro, MD, MS

University of Michigan Health System

Disclosure information not submitted.
Hallie Prescott, MD, MSc, FACP

University of Michigan, Michigan

Disclosure information not submitted.
EC

Erin Carlton, MD, MSc

University of Michigan CS Mott Children's Hospital

Disclosure(s): No relevant financial relationship(s) to disclose.

Introduction: Regionalization of pediatric centers offer centralized specialty care for critically ill children, but variation remains in follow-up care for the patients and families at the time of discharge. We hypothesize caregivers who live further from a pediatric healthcare system have increased desire for ICU follow-up care after hospital discharge, regardless of pre-existing conditions.

Methods: We conducted a single center survey of children aged 2 weeks-17 years and their caregivers, admitted to a PICU at a quaternary care center hospitalized with acute respiratory distress syndrome (ARDS), acute kidney injury (AKI) and/or sepsis. Caregivers completed surveys on child health and follow-up preferences at the time of enrollment (within 7 days of PICU admission). We compared characteristics among those with versus without preference to see a PICU physician after their child’s critical illness using chi-square and Wilcoxon rank sum. We used multivariable logistic regression to identify association of residential distance from the medical center with request for ICU follow-up after discharge, accounting for age and comorbidity status.

Results: Among 101 children, 54.5% were female, with a median age of 68 months (IQR 25-140), and 77.2% had a pre-existing comorbidity. 55.5% had ARDS, 37.6% had AKI, and 54.5% had sepsis. Median distance to the hospital was 37 miles (IQR 22-73). Of 97 who answered the question regarding ICU follow-up; 49% (n=48) stated PICU follow-up would be helpful, while 51% (n=49) did not. Characteristics were similar between those who did vs did not want ICU follow-up: median age 51 (20-157) vs 73 (31-134) months (p=0.72); 75% vs 78% had pre-existing comorbidities (p=0.20), and median residential distance to the hospital was 43 (IQR 22-81) versus 33 (IQR 21-54) miles (p=0.20). On multivariable regression, there was no association between distance to the hospital and request for follow-up (OR 1.01; 95% CI 0.99-1.02).

Conclusions: While nearly half of families requested PICU follow-up after discharge, residential distance from the hospital was not associated with desired follow-up. However, as regionalization of care continues, standardizing post PICU follow-up by ICU medical team member may further support patient and family recovery, particularly for those traveling greater distances.