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Rehospitalization during the first year of life by insurance status
Nicholas K Schiltz1, Beth Finkelstein Rosenthal2, Moira A Crowley2
1Case Western Reserve University, Cleveland, OH, USA Rainbow Babies and Children's Hospital, Cleveland, OH, USA nicholas.schiltz@case.edu.
Insights
Infants with Medicaid or no insurance face higher rehospitalization risks. Targeted postnatal care coordination is crucial for these vulnerable populations to reduce readmissions and healthcare costs.
Area of Science:
- Pediatrics
- Health Services Research
- Public Health
Background:
- Infant rehospitalization is a significant concern impacting healthcare costs and outcomes.
- Understanding factors influencing readmission is vital for developing effective interventions.
Purpose of the Study:
- To examine the relationship between insurance status and infant rehospitalization rates.
- To identify specific insurance-related predictors of infant readmission in a large population.
Main Methods:
- Longitudinal retrospective study analyzing 1-year post-discharge hospitalizations for over 200,000 infants.
- Utilized New York State Inpatient Database data from 2008.
- Employed multivariable negative binomial regression to estimate relative risk.
Main Results:
- 4.4% of infants were rehospitalized within one year.
- Medicaid coverage and lack of insurance were significant predictors of rehospitalization.
- Jaundice and acute bronchiolitis were leading causes for readmission.
Conclusions:
- Insurance status, particularly Medicaid and uninsurance, strongly influences infant rehospitalization.
- Further research should focus on preventable rehospitalizations and improved discharge/postnatal care coordination for at-risk infants.
Objective:
To assess the association of insurance status on infant rehospitalization in a population-based setting.
Methods:
In this longitudinal retrospective study, hospitalizations were tracked for 1 year after birth discharge for 203 031 infants born in hospitals during 2008 using data from the New York State Inpatient Database. Relative risk was estimated using multivariable negative binomial regression models.
Results:
Rehospitalization occurred in 9010 infants (4.4%). Medicaid coverage and being uninsured were strong predictors of rehospitalizations after adjustment for birth weight and other factors. Medicaid also bears a disproportionate share of the economic burden. Normal birth weight infants have the lowest risk, but comprise the majority of costs. Jaundice and acute bronchiolitis were the leading causes of rehospitalization within 30 days and 1 year, respectively.
Discussion:
Future research can explore the preventability of rehospitalizations, and evaluate novel strategies for discharge and postnatal care coordination especially for uninsured and Medicaid-enrolled infants.
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