Caregiver Shortage Means Longer Hospital Stays For Pediatric Home Health Patients

The shortage of home care nurses is keeping children who need their services in the hospital longer, according to a new study published by the American Academy of Pediatrics (AAP). Such delayed discharges come at a cost, considering how much more expensive inpatient hospital care is, compared with at-home care.

The study, which looked at four Minnesota children’s hospitals over the course of a year, involved more than 180 children with medical complexities (CMC). CMC are medically fragile, dependent on technology, have functional impairments or intensive care needs. Both new patients discharging to home health programs for the first time and existing patients were studied.

Researchers found new patients had the most problems accessing proper home care. About 68.5% of new patients and 9.2% of existing patients had their discharges delayed, and of those, lack of home care caused the vast majority — 91.9% — according to the study. On average, new patients were delayed about 54 days, while existing patients were delayed by about 36.


As such, researchers concluded that increasing access to home care nurses could reduce the length of costly hospital stays for CMC.

Large providers like Moorestown, New Jersey-based Bayada and Louisville, Kentucky-based BrightSpring are moving to serve younger home health patients, but with an industry-wide caregiver shortage, the answer isn’t that simple.

It’s a code providers are all trying to crack — how to recruit and retain caregivers to a job marked by low pay and inconsistent hours. The home health industry has a moral responsibility to figure out the answer, according to new commentary published by AAP in response to the study.


“If salaries for home care nurses are inadequate to attract enough skilled personnel, they must be increased,” wrote Garey Noritz, an internist and pediatrician at Nationwide Children’s Hospital and a American Academy of Pediatrics fellow. “If working conditions for nurses are unpleasant or unsafe, they must be improved.”

Medicaid managed care organizations and other insurers should work with home care agencies to improve the workforce, he went on to argue.

This will keep children out of the hospital and in their homes with their families where they belong,” he wrote. “This is better, safer, and cheaper. As usual, doing the right thing for children also makes good financial sense.”

Written by Bailey Bryant

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