Readmissions Following Hospitalization for Infection in Children With or Without Medical Complexity
-
Published:2021-02-17
Issue:3
Volume:16
Page:134-141
-
ISSN:1553-5606
-
Container-title:Journal of Hospital Medicine
-
language:
-
Short-container-title:J Hosp Med
Author:
Markham Jessica L,Hall Matt,Goldman Jennifer L,Bettenhausen Jessica L,Gay James C,Feinstein James,Simmons Julia,Doupnik Stephanie K,Berry Jay G
Abstract
OBJECTIVE: To describe the prevalence and characteristics of infection-related readmissions in children and to identify opportunities for readmission reduction and estimate associated cost savings.
STUDY DESIGN: Retrospective analysis of 380,067 nationally representative index hospitalizations for children using the 2014 Nationwide Readmissions Database. We compared 30-day, all-cause unplanned readmissions and costs across 22 infection categories. We used the Inpatient Essentials database to measure hospital-level readmission rates and to establish readmission benchmarks for individual infections. We then estimated the number of readmissions avoided and costs saved if hospitals achieved the 10th percentile of hospitals’ readmission rates (ie, readmission benchmark). All analyses were stratified by the presence/absence of a complex chronic condition (CCC).
RESULTS: The overall 30-day readmission rate was 4.9%. Readmission rates varied substantially across infections and by presence/absence of a CCC (CCC: range, 0%-21.6%; no CCC: range, 1.5%-8.6%). Approximately 42.6% of readmissions (n = 3,576) for children with a CCC and 54.7% of readmissions (n = 5,507) for children without a CCC could have been potentially avoided if hospitals achieved infection-specific benchmark readmission rates, which could result in an estimated savings of $70.8 million and $44.5 million, respectively. Bronchiolitis, pneumonia, and upper respiratory tract infections were among infections with the greatest number of potentially avoidable readmissions and cost savings for children with and without a CCC.
CONCLUSION: Readmissions following hospitalizations for infection in children vary significantly by infection type. To improve hospital resource use for infections, future preventative measures may prioritize children with complex chronic conditions and those with specific diagnoses (eg, respiratory illnesses).
Subject
Assessment and Diagnosis,Care Planning,Health Policy,Fundamentals and skills,General Medicine,Leadership and Management
Reference103 articles.
1. 1. Keren R, Luan X, Localio R, et al; Pediatric Research in Inpatient Settings
2. (PRIS) Network. Prioritization of comparative effectiveness research topics
3. in hospital pediatrics. Arch Pediatr Adolesc Med. 2012;166(12):1155-1164.
4. Prioritization of Comparative Effectiveness Research Topics in Hospital Pediatrics
5. 2. Van Horne B, Netherton E, Helton J, Fu M, Greeley C. The scope and trends