The role of timely follow-up and virtual support in pediatric care

David D’Arienzo, a PhD student at the Institute of Health Policy, Management, and Evaluation, an Academic General Pediatrics fellow at The Hospital for Sick Children, and a Leong Scholar, provides an update on his project. His research focuses on exploring timely post-discharge follow-up and virtual care in the transition from hospital to home, aiming to enhance safe discharge planning.

My experiences at the Edwin S.H. Leong Centre for Healthy Children and the Hospital for Sick Children have had a transformational impact on my career. The empowering mentorship, financial support, opportunities, and educational activities available at the Centre inspired me to pursue a career in research and transition from a Master of Science to a PhD Program.

My transition from an individual- to population-level approach to pediatric care is largely due to my supervisor Dr. Astrid Guttmann, Co-Director of the Edwin S.H. Leong Centre for Healthy Children. This shift required me to acquire new research skills and knowledge, which I did not have when I moved to Toronto. The funding from the Centre provided me with the protected time needed to develop these skills and grow as a researcher, allowing me to expand my initial project idea into a comprehensive PhD thesis proposal that addresses key questions in pediatric care and equity, using diverse methodologies.

I am fortunate to have been awarded a Canada Graduate Scholarship Doctoral Award from the Canadian Institutes of Health Research. This funding will support my research, titled “The Role of Timely Post-Discharge Follow-Up in the Transition from Hospital-to-Home for Children and Youth,” which focuses on safe discharge planning. Despite its importance, the transition from hospital-to-home remains a high-risk period for poor health outcomes in many children. While the use of timely post-discharge follow-up and virtual care in facilitating the transition period is growing, their effectiveness remains unclear. My projects utilize population-level data held at ICES to evaluate the quality, including the safety, effectiveness, and equity, of early follow-up after hospital discharge, including the use of virtual care in this context.

I aim to explore if the onset of virtual care is associated with a change in patients obtaining early post-discharge follow-up, and if it varies by equity factors. Additionally, I will identify predictors of early follow-up and whether early follow-up is associated with reduced 30-day readmissions and emergency department visits across seven of the most common and costly pediatric medical conditions resulting in hospitalizations.

These projects are intended to guide both policy decisions and clinical practice. Given the rapidly changing regulations and policies surrounding virtual care, the research aims to help policymakers on whether post-discharge care is being delivered equitably and to inform clinicians about which conditions may benefit most from early follow-up.

Since moving to Toronto in July 2022, I have published six articles in the field of child health and equity, developed advocacy programs to improve access to care to families living in poverty, advanced his clinical training through a fellowship at The Hospital for Sick Children, and completed my PhD coursework at the University of Toronto. I am grateful to the Edwin S.H. Leong Centre for Healthy Children for all their support throughout my journey.

I am excited to continue learning and growing at the Center from its incredible mentors and supervisors.