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Re-admissions to inpatient paediatric pulmonary rehabilitation
Douglas G Cushman1, Helene M Dumas, Stephen M Haley
1Kindred Hospital-Boston, 1515 Commonwealth Avenue, Brighton, MA 02135, USA. douglas.cushman@verizon.net
Insights
Children needing mechanical ventilation or oxygen during inpatient pulmonary rehabilitation often require readmission. Medical complexity and dependence on respiratory support may predict readmission needs.
Area of Science:
- Pediatric Pulmonology
- Rehabilitation Medicine
- Healthcare Outcomes Research
Background:
- Inpatient pediatric pulmonary rehabilitation programs aim to improve outcomes for children with complex respiratory conditions.
- Understanding readmission patterns is crucial for optimizing care and resource allocation.
Purpose of the Study:
- To determine readmission rates for children in inpatient pulmonary rehabilitation.
- To identify factors associated with readmission.
- To characterize children who require readmission.
Main Methods:
- A retrospective record review was conducted.
- The study included infants and toddlers (under three years) discharged from a pediatric pulmonary rehabilitation program between 1992 and 1999.
- Data on oxygen and ventilator support, nursing care, and acute care transfers were analyzed.
Main Results:
- Forty-one initial admissions led to 45 readmissions (mean 1.1 per child).
- Children with readmissions (54%) used significantly more ventilator support and nursing care, and had more frequent acute care transfers.
- Half of the readmitted children had two or more readmissions.
Conclusions:
- Dependence on supplemental oxygen and/or mechanical ventilation, along with medical complexity, may indicate a higher risk of readmission.
- Further analysis of readmission rates, reasons, and clinical characteristics could inform predictive models and practice improvements.
Objective:
To describe re-admission rates, identify reasons for re-admission and examine characteristics of children requiring re-admission to inpatient pulmonary rehabilitation.
Methodology:
Retrospective record review of infants and toddlers (less than three years of age) requiring oxygen or ventilator support discharged from an inpatient paediatric pulmonary rehabilitation programme between 1992 and 1999.
Results:
Forty-one initial admissions resulted in 45 readmissions with a mean re-admission rate of 1.1 (SD = 1.41) re-admissions per child. Children with re-admissions (n = 22, 54%) required significantly more ventilator support (p = 0.001) and nursing care (p = 0.001) and were transferred to acute care more frequently (p = 0.002) than children without re-admissions. One-half of the children re-admitted to inpatient pulmonary rehabilitation were re-admitted two or more times.
Conclusions:
Based on this cohort of children, dependence on supplemental oxygen and/or mechanical ventilation and medical complexity may be indicators that children will require re-admission to rehabilitation following a transfer back to acute care. Further examination of re-admission rates and reasons and children's clinical characteristics may have predictive value and provide practice improvement opportunities.