Rehospitalization During the First Year of Life by Insurance Status

Schiltz, Nicholas K.; Rosenthal, Beth; Crowley, Moira; Koroukian, Siran M.; Nevar, Ann; Meropol, Sharon B.; Cuttler, Leona

doi:10.1177/0009922814536924

Cited by 35 publications

(20 citation statements)

References 32 publications

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“…The New York SID also includes revisit variables that link multiple hospitalizations together to enable analyses of hospital readmissions. 13 These data have been used in previous studies evaluating trends in hospital readmissions among children 14 and adults. 15,16 We obtained data for live births in New York State from the New York Department of Health (http://www.health.ny.gov/statistics/vital_statistics/).…”

Section: Methodsmentioning

confidence: 99%

Risk of Hospital Readmission Among Infants With Neonatal Abstinence Syndrome

Patrick

Burke²,

Biel

et al. 2015

Hospital Pediatrics

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Objective Neonatal abstinence syndrome (NAS) is a postnatal drug withdrawal syndrome that may last for months. Our objective was to determine if infants with NAS are at increased risk for hospital readmission compared with uncomplicated term and late preterm newborns. Methods In this longitudinal retrospective cohort study, administrative data were used for all births from 2006 to 2009 in the New York State Inpatient Database. We identified infants with NAS, born late preterm or uncomplicated term, as independent groups using diagnostic codes and determined readmission rates. We fit a multivariable logistic regression model with 30-day readmission after discharge as the outcome and infant characteristics, clinical morbidities, insurance type, and length of birth hospitalization as predictors. Results From 2006 to 2009 in New York State, 700613 infants were classified as uncomplicated term, 51748 were born late preterm, and 1643 infants were diagnosed with NAS. After adjusting for confounders, infants with NAS (odds ratio [OR] 2.49, 95% confidence interval [CI] 1.75–3.55) were more likely than uncomplicated term infants to be readmitted within 30 days of birth hospitalizations. The risk of readmission was similar to late preterm infants (OR 2.26, 95% CI 2.09–2.45). Length of birth hospitalization in days was inversely related to odds of being readmitted within 30 days of birth hospitalization (OR 0.94 95% CI 0.92–0.96). Conclusions When compared with uncomplicated term infants, infants diagnosed with NAS were more than twice as likely to be readmitted to the hospital. Future research and state-level policies should investigate means to mitigate risk of hospital readmission for infants with NAS.

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Section: Methodsmentioning

confidence: 99%

Risk of Hospital Readmission Among Infants With Neonatal Abstinence Syndrome

Patrick

Burke²,

Biel

et al. 2015

Hospital Pediatrics

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“…During the first year of life, 4.4% to 9.5% of term infants are rehospitalized, with Medicaid patients being at increased risk compared with those with private insurance. 4,5 Rehospitalization and ED visits are stressful to the family and costly to the payer. Common conditions leading to early newborn rehospitalization identified in previous studies include jaundice, feeding issues, and infection.…”

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confidence: 99%

Hospital Admission and Emergency Department Utilization in an Infant Medicaid Population

Paul

Agiro

Hoffman

et al. 2016

Hospital Pediatrics

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A B S T R A C T BACKGROUND AND OBJECTIVE:In the first year of life, the rate of rehospitalization for infants has been shown to be between 4.4% and 9.5%. Reducing avoidable health care utilization is a population health priority. The goal of this study was to identify maternal and infant factors associated with rehospitalization and emergency department (ED) utilization in a cohort of newborn Medicaid recipients. METHODS:A longitudinal database was created by linking mother-infant dyads giving birth at a regional perinatal referral center with Delaware state Medicaid data. Multivariable logistic regression and negative binomial regression were used to examine inpatient hospitalization and ED utilization within 6 months after birth. RESULTS:The study cohort included 4112 infants; 452 (11.0%) were rehospitalized, and 1680 (41%) used the CONCLUSIONS:In this newborn Medicaid population, multiple maternal factors (including age, race, and mental health diagnoses) were associated with health care utilization in the 6 months after initial hospital discharge. Our data provide potential risk factors for targeted intervention and suggest that maternal factors should be considered in identifying a population at risk for rehospitalization and ED utilization.

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“…The cut‐off of five days in our study for hyperbilirubinaemic infants, who often require exchange transfusion after initial phototherapy and periodic TSB monitoring would appear realistic and more cost effective in a resource‐limited setting. However, given the limited space available in the emergency department, this LHS threshold would have resulted in denied admissions for even more critical patients, as well as other adverse consequences of overcrowding . Lowering the threshold well below five days would be a worthwhile way to optimise care.…”

Section: Discussionmentioning

confidence: 99%

“…For example, one study in the United States reported that infants readmitted for hyperbilirubinaemia spent 0–155 days in hospital at an average cost of about $990 (median $819, range $300–$9727) per day . This would suggest that a long hospital stay (LHS) for this condition is associated with substantial emotional and economic burdens and has an impact on patient overcrowding , especially in resource‐limited settings . Overcrowding, resulting from an excess demand or need for urgent medical attention beyond the available resources, has been associated with such adverse outcomes as decreased physician productivity, poorer quality of emergency care, increased medical errors and lower patient satisfaction .…”

Section: Introductionmentioning

confidence: 99%