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Readmission in children's emergency care: an analysis of hospital episode statistics
Peter Callery1, Richard G Kyle, Malcolm Campbell
1University of Manchester, Manchester, UK. peter.callery@manchester.ac.uk
Insights
Emergency paediatric readmission rates are linked to higher hospital admission volumes and same-day discharges. Hospital variations suggest other factors influence these readmissions, impacting care quality assessments.
Area of Science:
- Paediatric healthcare outcomes
- Hospital readmission analysis
- Public health surveillance
Background:
- Emergency readmissions for paediatric conditions are a key indicator of healthcare quality.
- Understanding factors influencing readmissions is crucial for improving patient outcomes and resource allocation.
- Previous studies have highlighted various determinants of readmission, but specific associations with hospital service characteristics require further investigation.
Purpose of the Study:
- To compare emergency paediatric readmission rates across different hospital services.
- To identify factors associated with readmission within 7 days of discharge for common childhood illnesses.
- To assess the utility of hospital episode statistics (HES) in evaluating emergency service outcomes.
Main Methods:
- Retrospective analysis of hospital episode statistics (HES) data from twelve hospitals in North West England.
- Inclusion of emergency admissions for children under 15 with breathing difficulty, feverish illness, or diarrhoea.
- Telephone survey to gather information on service provision.
Main Results:
- The overall readmission rate was 5.5% in 2006/2007.
- Higher proportions of same-day discharges were significantly associated with increased readmission rates, particularly for breathing difficulty and feverish illness.
- Hospitals with higher total annual admissions showed a significant association with higher readmission rates.
Conclusions:
- Emergency paediatric readmission rates are associated with higher annual admission volumes and a greater proportion of same-day discharges.
- Inter-hospital variations in readmission rates suggest the influence of unmeasured factors.
- HES data provides a valuable tool for assessing the outcomes of emergency paediatric services.
Aim:
To compare rates of emergency readmission following discharge for common paediatric conditions from a range of hospital services.
Design:
Retrospective analysis of hospital episode statistics (HES) and telephone survey of service provision.
Setting:
Twelve hospitals serving a metropolitan area in the North West of England.
Outcome Measures:
Emergency admissions to hospital within 7 days of discharge for breathing difficulty, feverish illness and/or diarrhoea.
Results:
HES were obtained for all children under 15 years of age discharged following emergency admission for breathing difficulty, feverish illness and/or diarrhoea during 2005/2006 (n=20,354) or 2006/2007 (n=23,018). The readmission rate for all hospitals in 2006/2007 was 5.5%. The percentage of same day discharges was associated with readmission (Kendall's tau(b) correlation=0.61, p=0.007). Readmissions were also associated with the proportion of same day discharges for breathing difficulty (Kendall's tau(b)=0.83, p<0.001) and feverish illness (Kendall's tau(b)=0.50, p=0.023) but not significantly so with diarrhoea (Kendall's tau(b)=0.37, p=0.098). The total number of admissions at a hospital in the year was associated with its readmission rate (Kendall's tau(b)=0.71, p=0.002). Most of the sample lived in the 40% most deprived areas in England, but there was no significant association between readmission and living in the 10% most deprived areas.
Conclusions:
Readmission rates are associated with higher numbers of annual admissions and higher proportions of children discharged on the day of admission. Variations between hospitals suggest that other factors can also affect readmission rates. Readmission rates calculated from HES can contribute to assessments of the outcome of emergency services.
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