Bucholz EM, et al. - Readmission causes and timing within the first 30 days after hospitalization for 3 acute and 3 chronic common pediatric conditions were assessed and compared in this analysis. Findings revealed that the timing and causes of pediatric readmissions vary greatly across pediatric conditions. Researchers reported that strategies for decreasing readmissions need to account for the index diagnosis to better target the highest risk period and causes for readmission to be effective.

Methods

• Using data from the 2013 to 2014 Nationwide Readmissions Database, the researchers investigated the daily percentage of readmissions occurring on days 1-30 and the leading causes of readmission after hospitalization for 3 acute (appendicitis, bronchiolitis/croup, and gastroenteritis) and 3 chronic (asthma, epilepsy, and sickle cell) conditions for patients aged 1-17 years (n = 2,753,488).
• Using Cox proportional hazards regression, data were analyzed.

Results

• After hospitalizations for sickle cell anemia, the 30-day readmission rates ranged from 2.6% (SE, 0.1) after hospitalizations for appendectomy to 19.1% (SE, 0.5).
• It was noted that more than 50% of 30-day readmissions after acute conditions occurred within 15 days after discharge.
• Readmissions after chronic conditions occurred more uniformly throughout the 30 days after discharge.
• Findings revealed that higher numbers of patient comorbidities were linked with increased risk of readmission at days 1-7, 8-15, and 16-30 after discharge for all conditions examined.
• According to the findings obtained, most 30-day readmissions after chronic conditions were for the same diagnosis or closely related conditions as the index admission (67% for asthma, 65% for seizure disorder, and 82% for sickle cell anemia) in contrast with 50% or fewer readmissions after acute conditions (46% for appendectomy, 47% for bronchiolitis/croup, and 19% for gastroenteritis).