Research Activities, July 2013
Pediatric readmission rates vary by condition and hospital type
A new study reveals that pediatric hospital readmission rates, one indicator of quality of care, vary by medical condition and hospital type. Researchers examined 568,845 admissions at 72 children’s hospitals in 34 States for patients 18 years and younger discharged during a 1-year period. They looked at readmissions for 10 conditions with the highest prevalence of readmission, defined as the first unplanned hospital admission within 30 days of the initial hospitalization. They also collected other patient and hospital characteristics.
The 30-day readmission rate for all hospitalized children was 6.5 percent. Among the children readmitted, 39 percent were sent back to the hospital in the first 7 days after discharge. The majority (61.6 percent) were readmitted in the first 14 days.
Readmission rates were higher (7.6 percent) for children aged 13 to 18 years compared to younger children (6.1 to 6.2 percent). Among children with chronic health conditions, children with cancer had the highest readmission rates (21.1 percent) and children with chronic respiratory diseases had the lowest rates (6.1 percent).
Readmission rates increased according to the number of chronic conditions present. The 10 admission diagnoses with the highest number of readmissions accounted for 27.7 percent of all readmissions. The highest readmission rates were observed with admissions for anemia or neutropenia, ventricular shunt procedures, and sickle cell anemia crisis.
Readmission rates also varied significantly across hospitals for 8 of the 10 diagnoses with the highest number of readmissions. Patients with public insurance had the highest readmission rate (6.9 percent), while the uninsured had the lowest rate (4.5 percent). Readmission rates were also higher for patients with longer initial hospital stays. The study was supported in part by AHRQ (HS20513).
See "Pediatric readmission prevalence and variability across hospitals," by Jay G. Berry, M.D., M.P.H., Sara L. Toomey, M.D., M.Phil., M.P.H., Alan M. Zaslavsky, Ph.D., and others in the January 23/30, 2013, Journal of the American Medical Association 309(4), pp. 372-380.