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Day of discharge and hospital readmission rates within 30 days in children: A population-based study
Carolyn E Beck1, Amina Khambalia, Patricia C Parkin
1Division of Paediatric Medicine and the Paediatric Outcomes Research Team, The Hospital for Sick Children and the University of Toronto, Toronto.
Insights
Friday hospital discharge does not increase readmission risk for children. Patient complexity and disease severity are key factors influencing pediatric readmissions within 30 days.
Area of Science:
- Pediatric hospital medicine
- Health services research
- Patient safety
Background:
- Adults discharged on Fridays face higher readmission rates.
- Pediatric readmission rates by discharge day remain understudied.
Purpose of the Study:
- To investigate the association between day of discharge and 30-day readmission risk in children.
- To identify factors influencing pediatric hospital readmissions.
Main Methods:
- Analysis of over 500,000 pediatric hospitalizations in Ontario (1996-2000).
- Comparison of readmitted vs. non-readmitted children.
- Multivariable modeling to control for confounders like age, diagnoses, and prior admissions.
Main Results:
- 3.4% of children experienced 30-day readmission.
- Friday discharge showed no significant increase in readmission risk (adjusted RR 1.07).
- Number of diagnoses, in-hospital complications, and prior admissions were significant predictors.
Conclusions:
- Pediatric hospital discharge on Friday is not linked to increased 30-day readmission.
- Patient complexity and disease severity are primary drivers of pediatric readmissions.
Background:
Adults discharged from hospital on a Friday are more likely to be readmitted within 30 days than are adults discharged midweek. No study has examined readmission rates for children by day of discharge.
Objective:
To determine the risk of readmission within 30 days by day of discharge in the paediatric population.
Methods:
The Canadian Institute for Health Information provided data on children 29 days to 18 years of age who were discharged from hospitals in Ontario between January 1996 and December 2000. Two groups of children (those who were readmitted within 30 days and those who were not) were compared on demographic and clinical characteristics. Multivariable modelling was used to account for potential confounding variables: age, sex, length of hospital stay, number of diagnoses, in-hospital operative procedure, in-hospital complication and hospital admission in the previous six months.
Results:
A total of 506,035 hospitalizations (involving 334,959 children) occurred over the study period. Of these children, 3.4% were readmitted within 30 days of discharge. In total, 3.6% of children discharged on a Friday were readmitted within 30 days compared with 3.3% of children discharged on a Wednesday. After adjusting for patient and hospital factors, Friday discharge was not associated with readmission within 30 days (adjusted RR 1.07, 95% CI 0.99 to 1.15). More significant predictors of readmission included number of diagnoses, in-hospital complications and hospital admission in the six months previous to the index admission date.
Conclusion:
Risk of readmission within 30 days is not significantly increased for children discharged on a Friday compared with children discharged midweek. Significant risk factors for hospital readmission are patient complexity and disease severity.
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