In our quest to keep children healthy and out of the hospital, we have certainly embraced the concept of establishing a medical home—but what happens when that medical home has to change perhaps because a family has moved to a new area entirely –especially when such moves occur in the first year of life. Hutchings et al. (peds.2015-2836) decided to follow a cohort of more than 200,000 children born in Wales and monitor their health outcomes in association with residential moves in an infant’s first year of life.
The main outcome studied involved emergency admissions for possible preventable hospitalizations between ages 1 and 5. The results are quite surprising in that admissions increased substantially if there were home moves in the first year of life and worsened even more if more than one move occurred. What kinds of illnesses are we talking about that might have been preventable? The authors describe upper respiratory infections, concussions with resultant seizures and other injuries, dehydration from gastroenteritis, uncontrolled asthma, influenza, and dental conditions as leading the list of preventable conditions.
So what can we do to prevent these preventable admissions from occurring when these patients move away from us? We can certainly make sure they are plugged into a new medical home and have had a first visit while we still stay involved and engaged in trying to help those mobile families get their new medical source of care. Our lack of attention to this may make us accessories to the cause of a preventable hospital admission. Read this study and then reflect on how strong the transitions are from your practice to another for families who move their home location in a baby’s first year of life.