An analysis of patient readmissions in pediatric hospitals found than many of the trends seen in adult hospital readmissions hold true in children’s hospitals too.
On average, the analysis found that 6.5 percent of patients discharged from children’s hospital were readmitted unexpectedly within 30 days. Among conditions with the highest readmission rates, though, the numbers were comparable to the near-20 percent figures associated with heart attack, heart failure and pneumonia readmissions in adult hospitals. The conditions most frequently associated with returns to pediatric hospitals were anemia/neutropenia, ventricular shunt procedures and sickle-cell crises.
Researchers at Boston Children’s Hospital analyzed readmission data from the National Association of Children’s Hospitals and Related Institutions for 72 large acute-care children’s hospitals between July 2009 and June 2010. Their findings were published in the latest issue of the Journal of the American Medical Association.
What they found was that many trends seen in adult readmissions were true among children too. Rates varied across hospitals and ranged from 4.6 percent to 8.5 percent, likely due to a variety of factors including differences in hospital care, follow-up care and family or community factors that influence health, the researchers said in a Boston Children’s announcement about the study.
“The variation we found in readmission rates at different hospitals suggests that there is room to improve,” said Dr. Mark Schuster, chief of general pediatrics at Boston Children’s Hospital in the statement. “The effort, though, will involve more than just hospitals. Community clinicians and organizations have a role to play as well. Parents also need support in being able to stay home with their recuperating children.”
Rates also varied heavily between conditions. As in adults, the largest volume of readmissions occurred among patients with chronic diseases.
Similar to a study of adult readmissions in VA hospitals, this analysis found that a shorter hospital stay was associated with lower readmission rates. And, as with adults, readmission rates were higher among children with public or no insurance, the authors noted.
“To date, hospitals that care for children have not been targeted by the (Hospital Readmission Reduction Program), but often policies that start in adult hospitals eventually migrate to hospitals that care for children,” Drs. Rajendu Srivastava of the University of Pennsylvania School of Medicine and Ron Keren of University of Utah Health Sciences Center wrote in an accompanying editorial. “If that happens, then the study […] will take on substantial significance.”