Pediatric surgical readmissions

Are they truly preventable?

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background/purpose Reimbursement penalties for excess hospital readmissions have begun for the pediatric population. Therefore, research determining incidence and predictors is critical. Methods A retrospective review of University HealthSystem Consortium database (N = 258 hospitals; 2,723,621 patients) for pediatric patients (age 0–17 years) hospitalized from 9/2011 to 3/2015 was performed. Outcome measures were 7-, 14-, and 30-day readmission rates. Hospital and patient characteristics were evaluated to identify predictors of readmission. Results Readmission rates at 7, 14, and 30 days were 2.1%, 3.1%, and 4.4%. For pediatric surgery patients (N = 260,042), neither index hospitalization length of stay (LOS) nor presence of a complication predicted higher readmissions. Appendectomy was the most common procedure leading to readmission. Evaluating institutional data (N = 5785), patients admitted for spine surgery, neurosurgery, transplant, or surgical oncology had higher readmission rates. Readmission diagnoses were most commonly infectious (37.2%) or for nausea/vomiting/dehydration (51.1%). Patients with chronic medical conditions comprised 55.8% of patients readmitted within 7 days. 92.0% of patients requiring multiple rehospitalizations had comorbidities. Conclusions Readmission rates for pediatric patients are significantly lower than adults. Risk factors for adult readmissions do not predict pediatric readmissions. Readmission may be a misnomer for the pediatric surgical population, as most are related to chronic medical conditions and other nonmodifiable risk factors. Level of Evidence Level IV.

Original languageEnglish (US)
Pages (from-to)161-165
Number of pages5
JournalJournal of Pediatric Surgery
Volume52
Issue number1
DOIs
StatePublished - Jan 1 2017

Fingerprint

Pediatrics
Patient Readmission
Appendectomy
Neurosurgery
Dehydration
Nausea
Population
Vomiting
Comorbidity
Length of Stay
Hospitalization
Spine
Outcome Assessment (Health Care)
Databases
Transplants
Incidence
Research

Keywords

  • Preventable
  • Quality improvement
  • Readmission
  • Surgery

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

Pediatric surgical readmissions : Are they truly preventable? / Brown, Erin; Anderson, Jamie; Burgess, Debra; Bold, Richard J; Farmer, Diana L.

In: Journal of Pediatric Surgery, Vol. 52, No. 1, 01.01.2017, p. 161-165.

Research output: Contribution to journalArticle

@article{78d35f3a690546f6b8c4b7f7c90e0eda,
title = "Pediatric surgical readmissions: Are they truly preventable?",
abstract = "Background/purpose Reimbursement penalties for excess hospital readmissions have begun for the pediatric population. Therefore, research determining incidence and predictors is critical. Methods A retrospective review of University HealthSystem Consortium database (N = 258 hospitals; 2,723,621 patients) for pediatric patients (age 0–17 years) hospitalized from 9/2011 to 3/2015 was performed. Outcome measures were 7-, 14-, and 30-day readmission rates. Hospital and patient characteristics were evaluated to identify predictors of readmission. Results Readmission rates at 7, 14, and 30 days were 2.1{\%}, 3.1{\%}, and 4.4{\%}. For pediatric surgery patients (N = 260,042), neither index hospitalization length of stay (LOS) nor presence of a complication predicted higher readmissions. Appendectomy was the most common procedure leading to readmission. Evaluating institutional data (N = 5785), patients admitted for spine surgery, neurosurgery, transplant, or surgical oncology had higher readmission rates. Readmission diagnoses were most commonly infectious (37.2{\%}) or for nausea/vomiting/dehydration (51.1{\%}). Patients with chronic medical conditions comprised 55.8{\%} of patients readmitted within 7 days. 92.0{\%} of patients requiring multiple rehospitalizations had comorbidities. Conclusions Readmission rates for pediatric patients are significantly lower than adults. Risk factors for adult readmissions do not predict pediatric readmissions. Readmission may be a misnomer for the pediatric surgical population, as most are related to chronic medical conditions and other nonmodifiable risk factors. Level of Evidence Level IV.",
keywords = "Preventable, Quality improvement, Readmission, Surgery",
author = "Erin Brown and Jamie Anderson and Debra Burgess and Bold, {Richard J} and Farmer, {Diana L}",
year = "2017",
month = "1",
day = "1",
doi = "10.1016/j.jpedsurg.2016.10.037",
language = "English (US)",
volume = "52",
pages = "161--165",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
publisher = "W.B. Saunders Ltd",
number = "1",

}

TY - JOUR

T1 - Pediatric surgical readmissions

T2 - Are they truly preventable?

AU - Brown, Erin

AU - Anderson, Jamie

AU - Burgess, Debra

AU - Bold, Richard J

AU - Farmer, Diana L

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background/purpose Reimbursement penalties for excess hospital readmissions have begun for the pediatric population. Therefore, research determining incidence and predictors is critical. Methods A retrospective review of University HealthSystem Consortium database (N = 258 hospitals; 2,723,621 patients) for pediatric patients (age 0–17 years) hospitalized from 9/2011 to 3/2015 was performed. Outcome measures were 7-, 14-, and 30-day readmission rates. Hospital and patient characteristics were evaluated to identify predictors of readmission. Results Readmission rates at 7, 14, and 30 days were 2.1%, 3.1%, and 4.4%. For pediatric surgery patients (N = 260,042), neither index hospitalization length of stay (LOS) nor presence of a complication predicted higher readmissions. Appendectomy was the most common procedure leading to readmission. Evaluating institutional data (N = 5785), patients admitted for spine surgery, neurosurgery, transplant, or surgical oncology had higher readmission rates. Readmission diagnoses were most commonly infectious (37.2%) or for nausea/vomiting/dehydration (51.1%). Patients with chronic medical conditions comprised 55.8% of patients readmitted within 7 days. 92.0% of patients requiring multiple rehospitalizations had comorbidities. Conclusions Readmission rates for pediatric patients are significantly lower than adults. Risk factors for adult readmissions do not predict pediatric readmissions. Readmission may be a misnomer for the pediatric surgical population, as most are related to chronic medical conditions and other nonmodifiable risk factors. Level of Evidence Level IV.

AB - Background/purpose Reimbursement penalties for excess hospital readmissions have begun for the pediatric population. Therefore, research determining incidence and predictors is critical. Methods A retrospective review of University HealthSystem Consortium database (N = 258 hospitals; 2,723,621 patients) for pediatric patients (age 0–17 years) hospitalized from 9/2011 to 3/2015 was performed. Outcome measures were 7-, 14-, and 30-day readmission rates. Hospital and patient characteristics were evaluated to identify predictors of readmission. Results Readmission rates at 7, 14, and 30 days were 2.1%, 3.1%, and 4.4%. For pediatric surgery patients (N = 260,042), neither index hospitalization length of stay (LOS) nor presence of a complication predicted higher readmissions. Appendectomy was the most common procedure leading to readmission. Evaluating institutional data (N = 5785), patients admitted for spine surgery, neurosurgery, transplant, or surgical oncology had higher readmission rates. Readmission diagnoses were most commonly infectious (37.2%) or for nausea/vomiting/dehydration (51.1%). Patients with chronic medical conditions comprised 55.8% of patients readmitted within 7 days. 92.0% of patients requiring multiple rehospitalizations had comorbidities. Conclusions Readmission rates for pediatric patients are significantly lower than adults. Risk factors for adult readmissions do not predict pediatric readmissions. Readmission may be a misnomer for the pediatric surgical population, as most are related to chronic medical conditions and other nonmodifiable risk factors. Level of Evidence Level IV.

KW - Preventable

KW - Quality improvement

KW - Readmission

KW - Surgery

UR - http://www.scopus.com/inward/record.url?scp=85007453165&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85007453165&partnerID=8YFLogxK

U2 - 10.1016/j.jpedsurg.2016.10.037

DO - 10.1016/j.jpedsurg.2016.10.037

M3 - Article

VL - 52

SP - 161

EP - 165

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

SN - 0022-3468

IS - 1

ER -