Hospital Readmissions and In-Home Skilled Nursing

The central finding is specific, not blanket: general home health care does not reliably reduce readmissions across broad populations, but the evidence changes for medically complex children who rely on ventilators, feeding tubes, tracheostomies, gastrostomy tubes, and other life-sustaining technology. Pediatric research identifies lack of skilled home nursing as a primary readmission driver through parental exhaustion and gaps in clinical expertise at home. A Journal of Perinatology NICU discharge cohort of 421 medically complex infants found a median 70.1-day wait for skilled home nursing, with the longest wait reaching 428 days.

• A multi-hospital U.S. adult cohort study found adjusted readmission rates for general home health patients up to 1.5 percentage points higher than comparable patients without home health visits.
• The report distinguishes broad adult home health findings from pediatric evidence focused on medically complex children with technology dependence.
• Sobotka and colleagues identified lack of home nursing as a primary driver of readmission for children with medical technology dependence.
• The pediatric readmission pathway operates through two mechanisms: accumulated parental caregiver exhaustion and lack of on-site clinical expertise during acute complications.
• A Journal of Perinatology cohort tracked 421 medically complex infants discharged from the NICU with a tracheostomy or gastrostomy tube.
• The median wait for skilled home nursing after complex NICU discharge was 70.1 days, and the maximum documented wait was 428 days.
• The reviewed research states that the nursing gap prevented improvements in NICU-to-home transitions even when other readmission-prevention measures were working.

Research Partner

Prestige Health Partners

Study ID

ASBRC-2026-025

Geography

United States / Georgia context

Industry

Skilled home health nursing

Research Area

Healthcare & Family Business Insight

Primary Data Sources

Multi-hospital U.S. adult cohort analysis of home health care and readmission outcomes, Sobotka et al., Pediatric Pulmonology, study of children with medical technology dependence, Journal of Perinatology NICU discharge cohort tracking 421 medically complex infants with tracheostomy or gastrostomy tube, NIH-registered clinical trial at Brenner Children's Hospital examining structured interagency collaboration models

Publication Date

October 2026

Status

Published

This research review finds that broad adult home health care evidence is mixed, but pediatric studies focused on children with medical technology dependence identify lack of skilled home nursing as a readmission driver and document a median 70.1-day wait for nursing after complex NICU discharge.

For Georgia families navigating complex pediatric discharge, the practical question is not whether any home health visit reduces readmissions. The evidence points to consistent skilled nursing for medically complex children as the intervention that addresses caregiver exhaustion and the clinical-expertise gap at home.

This report synthesizes peer-reviewed clinical literature examining the relationship between in-home skilled nursing and hospital readmission rates, with particular focus on medically complex pediatric populations. No proprietary data was collected. Studies were selected based on population specificity, outcome relevance, and publication in peer-reviewed journals, then analyzed comparatively to distinguish broad population findings from subgroup-specific pediatric findings.

This synthesis does not constitute a systematic review or meta-analysis. Study-level metadata including sample demographics, methodology design, and publication years were not fully available for independent verification within the report's scope. Adult population findings are not directly transferable to pediatric conclusions. No Georgia-specific readmission data was independently analyzed.

• Multi-hospital U.S. adult cohort analysis of home health care and readmission outcomes
• Sobotka et al., Pediatric Pulmonology, study of children with medical technology dependence
• Journal of Perinatology NICU discharge cohort tracking 421 medically complex infants with tracheostomy or gastrostomy tube
• NIH-registered clinical trial at Brenner Children's Hospital examining structured interagency collaboration models

Prestige Health Partners provided Georgia home health context for families seeking skilled in-home nursing services after complex discharge. The report applies published U.S. hospital and NICU research to families in Atlanta and across Georgia, but it does not analyze proprietary Prestige patient data.

• Full Report PDF: Full report PDFAvailable
• Executive Summary: Executive summaryAvailable
• Methodology: Methodology notesAvailable
• Citation: American Small Business Research Center. Hospital Readmissions and In-Home Skilled Nursing. ASBRC-2026-025. October 2026.Available
• Press Release: Press releaseAvailable
• Charts: ChartsComing Soon
• Media Kit: Media kitComing Soon

American Small Business Research Center. Hospital Readmissions and In-Home Skilled Nursing. ASBRC-2026-025. October 2026.

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Prestige Health Partners. Research partners may provide topic context, access to subject matter expertise, or financial support for the research process. The American Small Business Research Center maintains editorial independence. Research partners do not determine findings, methodology, conclusions, or publication decisions.