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Factors Associated with Readmission of Pediatric Patients in a Developing Nation
Dinesh Kumar1, Swarnim Swarnim2, Gurleen Sikka3
1Division of Pediatric Cardiology, Post Graduate Institute of Medical Education & Research and Dr Ram Manohar Lohia Hospital, New Delhi, India. dineshkumar169@yahoo.co.in.
Insights
Pediatric readmissions in developing nations are often linked to the initial illness and social factors. Addressing these can help prevent future hospitalizations.
Area of Science:
- Pediatric Healthcare
- Public Health
- Epidemiology
Background:
- Hospital readmissions in pediatric patients are a significant concern, particularly in developing nations.
- Understanding the factors contributing to readmission is crucial for improving patient outcomes and healthcare resource allocation.
Purpose of the Study:
- To determine the incidence of pediatric readmissions in a tertiary care hospital in a developing country.
- To identify patient-specific and hospital-specific factors associated with these readmissions.
Main Methods:
- A prospective study was conducted over one year at a tertiary care hospital.
- Included were pediatric patients aged 1 month to 15 years readmitted within 60 days of discharge.
- Risk factors were assessed through medical record review and questionnaires, categorizing causes as patient-specific, hospital-specific, or unrelated.
Main Results:
- The overall pediatric readmission rate was 3%, with 80.66% causally linked to the initial admission.
- Significant risk factors included sociodemographic characteristics (low socioeconomic status, lack of health information, migration) and patient factors (cardiac disease, anemia, malnutrition, developmental delay).
- Patient-specific factors (48.66%) were the leading cause of readmission, followed by hospital-specific factors (38%).
Conclusions:
- The progression of primary illness and social determinants are key contributors to pediatric readmissions in developing countries.
- Further multicentric studies are recommended to assess readmission rates across different hospitals and explore preventability.
- Interventions targeting social determinants and patient-specific factors may reduce pediatric readmissions.
Objectives:
To determine the incidence of readmission in pediatric patients in a tertiary care hospital in a developing nation and to ascertain factors precipitating readmissions.
Methods:
A prospective study was conducted from February 2016 through January 2017 at a tertiary care hospital. Children between 1 mo to 15 y of age were included if they were readmitted within 60 d of discharge. The risk factors for readmission were determined on the basis of medical record review and a structured questionnaire and the ascribed cause of readmission was grouped into three categories: Patient specific factors, Hospital specific factors and Unrelated/ New illness.
Results:
The readmission rate was 3%, out of which 80.66% were found to be causally related to the index admission. Several sociodemographic characteristics i.e. lack of health information like television, lower socioeconomic status, absence of adequate breastfeeding, lower age, migrants were found to be significantly associated with readmission along with other patient specific factors like presence of cardiac disease, presence of comorbid conditions like anemia, malnutrition, and global developmental delay. The most important cause for readmission was determined as patient specific (48.66%) followed by hospital specific (38%) and unknown/unrelated factors (13.33%).
Conclusions:
The progression of the primary illness and social determinants of pediatric readmissions are important contributing risk factors for readmission in developing countries in pediatric patients. Multicentric studies are needed from this region of the world to include different hospital readmissions rate and to address the issue of potential preventability of pediatric readmissions.
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