Preventing Pediatric Readmissions: How Does the Hospital Fit In?

Brittan, Mark; Shah, Samir S.; Auger, Katherine A.

doi:10.1542/peds.2016-1643

Cited by 11 publications

(9 citation statements)

References 16 publications

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“…Extrapolating from the largest pediatric study on readmission preventability, 8 it is estimated that only two in 100 pediatric hospitalizations results in a PPR. 16 Given the lack of robust pediatric readmission prediction tools, the ability to prospectively identify children at high risk for readmission and target interventions is challenging. Second, as we have previously described, children are readmitted after hospitalization for a wide variety of conditions.…”

Section: Discussionmentioning

confidence: 99%

Progress (?) Toward Reducing Pediatric Readmissions

Auger

Harris

Teufel

et al. 2019

Journal of Hospital Medicine

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Many children's hospitals are actively working to reduce readmissions to improve care and avoid financial penalties. We sought to determine if pediatric readmission rates have changed over time. We used data from 66 hospitals in the Inpatient Essentials Database including index hospitalizations from January, 2010 through June, 2016. Seven‐day all cause (AC) and potentially preventable readmission (PPR) rates were calculated using 3M PPR software. Total and condition‐specific quarterly AC and PPR rates were generated for each hospital and in aggregate. We included 4.52 million hospitalizations across all study years. Readmission rates did not vary over the study period. The median seven‐day PPR rate across all quarters was 2.5% (range 2.1%‐2.5%); the median seven‐day AC rate across all quarters was 5.1% (range 4.3%‐5.3%). Readmission rates for individual conditions fluctuated. Despite significant national efforts to reduce pediatric readmissions, both AC and PPR readmission rates have remained unchanged over six years.

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Section: Discussionmentioning

confidence: 99%

Progress (?) Toward Reducing Pediatric Readmissions

Auger

Harris

Teufel

et al. 2019

Journal of Hospital Medicine

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“…29 -31 Many hospitals have implemented readmission reduction efforts to support patients and families during the stressful periods of hospitalization, transition, and postdischarge. 24,32 Specifically, interventions that enhance education and support postdischarge needs (eg, follow-up support in person or via phone, nurse home visitation, and connections to communitybased resources) are being trialed to assist families and, ideally, reduce readmission rates. 16,33,34 Our findings reveal the potential need for additional supports to be integrated into routine hospital-based care (eg, parking vouchers, meals for family members, and transportation reimbursement).…”

Section: Discussionmentioning

confidence: 99%

Lost Earnings and Nonmedical Expenses of Pediatric Hospitalizations

Chang¹,

Shah

Hoefgen

et al. 2018

Pediatrics

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“…Limiting rehospitalisations is a key challenge facing health systems as they are associated with large costs and inconvenience to patients and providers [10–12]. Thirty-day rehospitalisations are a particular focus for health providers [13–15]. Rehospitalisation rates amongst preterms have been found to be significantly higher than those of full-term infants [16–18].…”

Section: Introductionmentioning

confidence: 99%

Assessing the risk of early unplanned rehospitalisation in preterm babies: EPIPAGE 2 study

et al. 2019

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BackgroundGaining a better understanding of the probability, timing and prediction of rehospitalisation amongst preterm babies could help improve outcomes. There is limited research addressing these topics amongst extremely and very preterm babies. In this context, unplanned rehospitalisations constitute an important, potentially modifiable adverse event. We aimed to establish the probability, time-distribution and predictability of unplanned rehospitalisation within 30 days of discharge in a population of French preterm babies.MethodsThis study used data from EPIPAGE 2, a population-based prospective study of French preterm babies. Only those babies discharged home alive and whose parents responded to the one-year survey were eligible for inclusion in our study. For Kaplan-Meier analysis, the outcome was unplanned rehospitalisation censored at 30 days. For predictive modelling, the outcome was binary, recording unplanned rehospitalisation within 30 days of discharge. Predictors included routine clinical variables selected based on expert opinion.ResultsOf 3841 eligible babies, 350 (9.1, 95% CI 8.2–10.1) experienced an unplanned rehospitalisation within 30 days. The probability of rehospitalisation progressed at a consistent rate over the 30 days. There were significant differences in rehospitalisation probability by gestational age. The cross-validated performance of a ten predictor model demonstrated low discrimination and calibration. The area under the receiver operating characteristic curve was 0.62 (95% CI 0.59–0.65).ConclusionsUnplanned rehospitalisation within 30 days of discharge was infrequent and the probability of rehospitalisation progressed at a consistent rate. Lower gestational age increased the probability of rehospitalisation. Predictive models comprised of clinically important variables had limited predictive ability.

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Preventing Pediatric Readmissions: How Does the Hospital Fit In?

Cited by 11 publications

References 16 publications

Progress (?) Toward Reducing Pediatric Readmissions

Progress (?) Toward Reducing Pediatric Readmissions

Lost Earnings and Nonmedical Expenses of Pediatric Hospitalizations

Assessing the risk of early unplanned rehospitalisation in preterm babies: EPIPAGE 2 study

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