Enhancing NSQIP-Pediatric through integration with the Pediatric Health Information System

Area of Science:

• Pediatric Surgery
• Health Services Research
• Data Linkage

Background:

• The National Surgical Quality Improvement Program-Pediatric (NSQIP-Peds) and Pediatric Health Information System (PHIS) are crucial for assessing pediatric surgical care.
• Investigating healthcare utilization in the first post-operative year requires comprehensive data linkage.
• Linking disparate datasets can offer a more complete picture of patient outcomes.

Purpose of the Study:

• To implement and validate a linkage algorithm between NSQIP-Peds and PHIS datasets.
• To investigate healthcare utilization, including emergency department (ED) visits and hospital readmissions, within the first post-operative year.
• To assess the rates of potentially preventable readmissions (PPR) and associated hospital charges.

Main Methods:

• Cases from NSQIP-Peds and PHIS at a single institution between January 2010 and September 2011 were linked.
• Matching criteria included gender and dates of birth, admission, and discharge.
• True match rates were validated using medical records; subsequent analysis examined ED visits, readmissions, PPR, and charges.

Main Results:

• A high linkage rate of 93.6% was achieved, with 92.5% confirmed as true matches.
• Post-operative ED visit rates were 7.8% (0-30 days), 17.2% (31-180 days), and 18.1% (181-365 days).
• Readmission rates were 5.5% (0-30 days), 9.3% (31-180 days), and 8.4% (181-365 days), with 23.7% of inpatient procedure readmissions being potentially preventable within a year.

Conclusions:

• A linked NSQIP-Peds-PHIS dataset, using indirect identifiers, effectively captures high rates of post-operative ED visits and readmissions.
• This linked dataset provides a robust tool for comprehensive study of healthcare utilization and clinical outcomes in pediatric surgical patients.
• The findings highlight significant healthcare needs in the first post-operative year, emphasizing the importance of post-discharge monitoring and care coordination.