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Demographic factors associated with bronchiolitis readmission
Jeffrey Riese1, Russell J McCulloh, Kristin L Koehn
1Department of Pediatrics, Rhode Island Hospital/Hasbro Children's Hospital, Providence, Rhode Island; and.
Insights
Younger children and those from lower socioeconomic backgrounds face higher readmission rates after bronchiolitis hospitalization. Inpatient medical care did not appear to influence these readmission risks.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Health Services Research
Background:
- Bronchiolitis is a common pediatric respiratory infection requiring hospitalization.
- Understanding readmission factors is crucial for improving care and reducing healthcare costs.
Purpose of the Study:
- To investigate patient characteristics and medical management associated with hospital readmission in children diagnosed with bronchiolitis.
Main Methods:
- Retrospective chart review of 1229 children admitted with bronchiolitis across two children's hospitals.
- Data collected included demographics, treatments, length of stay, and outcomes.
- Univariate analyses identified risk factors for 4-week readmission.
Main Results:
- Younger children (mean age 4.5 months) had higher readmission rates than older children (mean age 5.7 months).
- Patients from lower income zip codes and those living closer to the hospital (within 20 miles) showed increased readmission likelihood.
- No specific inpatient medical intervention or length of stay was associated with readmission risk.
Conclusions:
- Bronchiolitis readmission rates were 6.4% overall.
- No modifiable inpatient medical management factors were identified as significantly associated with readmission.
- Socioeconomic factors and patient age appear to be key determinants of bronchiolitis readmission.
Objectives:
The goal of this study was to evaluate patient characteristics and medical management and their association with readmission in children with bronchiolitis.
Methods:
This retrospective chart review included children admitted with bronchiolitis to 2 children's hospitals. Reviewers selected charts based on International Classification of Diseases, Ninth Revision, diagnosis and collected information on demographic characteristics, treatment, diagnostic testing, length of stay, and adverse outcomes. Univariate analyses were used to identify risk factors associated with any-cause readmission in 4 weeks.
Results:
A total of 1229 patients met inclusion criteria. Younger children were more likely to be readmitted within 4 weeks of discharge compared with older children (mean age: 4.5 vs 5.7 months; P = .005). Readmissions did not differ based on length of stay, and no medical intervention was associated with risk for readmission. Of patients readmitted from the large service area hospital, 57% lived ≤20 miles away, compared with 26.9% of those who were not readmitted (P = .03). Patients from the lowest income zip codes within the catchment area of the small service area hospital were more likely to be readmitted compared with patients from the highest income zip codes (7.8% vs 0%; P = .025).
Conclusions:
Overall, 6.4% of hospitalized patients with bronchiolitis were readmitted. Our data did not identify any inpatient medical management or modifiable risk factor associated with readmission.
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