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Hospital readmissions in paediatric trauma patients: A 10-year Australian review
Annalise Unsworth1, Kate Curtis2, Rebecca J Mitchell3
1Department of Emergency Medicine, Royal North Shore Hospital, Sydney, New South Wales, Australia.
Insights
Paediatric trauma readmissions in Australia occur due to injury or complications, costing AU$108 million. Preventing complications is key to reducing this burden on the healthcare system.
Area of Science:
- Trauma Surgery
- Paediatric Healthcare
- Health Economics
Background:
- Paediatric trauma readmissions increase hospital stays, procedures, and healthcare costs.
- Nationwide data on paediatric trauma readmission rates and causes outside the USA are limited.
- This study provides the first Australian nationwide analysis of paediatric trauma readmissions.
Purpose of the Study:
- To determine the rates, causes, and costs of paediatric trauma readmissions in Australia.
- To identify characteristics of paediatric trauma patients readmitted within 28 days.
- To inform strategies for reducing readmission burdens.
Main Methods:
- Retrospective analysis of linked hospitalisation and mortality data (2001-2012).
- Inclusion of injured children aged 16 years or younger.
- Extraction of data on injury severity, nature of injury, episodes of care, and costs.
Main Results:
- A total of 37,603 paediatric trauma patients were readmitted within 28 days, a rate of 5.5%.
- Fractures (52.6%) and burns (19.3%) were the most common reasons for readmission.
- Readmissions cost AU$108 million, with 66% due to injury or complications and 30% for procedures/follow-up.
Conclusions:
- Paediatric trauma readmissions in Australia are primarily caused by injury or its complications, incurring substantial costs.
- There is a need for early identification of at-risk patients.
- Preventing complications is crucial to alleviate the ongoing burden of paediatric trauma readmissions.
Aim:
Readmission of paediatric trauma patients is associated with increased hospital length of stay, additional operative procedures and significant costs to the health-care system. The rates and causes of readmission of paediatric trauma patients are not well reported outside of the USA or single centres. This nation-wide study is the first in Australia to examine the readmission rates, costs and characteristics of Australian paediatric trauma patients.
Methods:
This was a retrospective examination of linked hospitalisation and mortality data for injured children aged 16 or younger from 1 July 2001 to 30 June 2012, readmitted to hospital within 28 days of discharge. Data including injury severity, nature of injury, episodes of care and costs were extracted from hospitalisation data.
Results:
There were 37 603 injury children aged ≤16 years readmitted to hospital within 28 days during the 10-year period, a readmission rate of 5.5%. The most common principal injury requiring readmission was fracture (52.6%) and burns (19.3%). A total of 66% of all patients had a readmission diagnosis of injury, complication of their initial injury or complication of surgical and medical care; 30% were readmitted for a specific procedure or follow-up care. The total cost of readmissions was AU$108 million.
Conclusions:
Hospital readmission rates of paediatric trauma patients in Australia are due to injury or a complication of injury and are associated with significant costs. Early identification of at-risk patients and the prevention of complications are needed to prevent the ongoing burden of readmission.
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