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[Detection of risk factors for preventable paediatric hospital readmissions]
Jimena Pérez-Moreno1, Andrea María Leal-Barceló1, Elena Márquez Isidro1
1Hospital General Universitario Gregorio Marañón, Hospital materno-infantil, Servicio de Pediatría, Sección Pediatría Hospitalizados. Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, España.
Insights
High hospital occupancy increases paediatric readmissions. Managing chronic conditions and reducing emergency visits can prevent readmissions in children.
Area of Science:
- Pediatric healthcare quality
- Hospital readmission analysis
- Preventable adverse events
Background:
- Readmission rates serve as a key performance indicator for hospital quality.
- Identifying factors contributing to paediatric readmissions is crucial for improving care.
Purpose of the Study:
- To identify potential factors contributing to preventable paediatric readmissions.
- To analyze the relationship between hospital care pressure and readmission rates.
Main Methods:
- A 3.5-year descriptive, analytical, longitudinal study was conducted at a tertiary hospital's pediatric ward.
- Readmissions were categorized (very early, early, late), with preventable readmissions defined as those within 15 days for the same reason.
- Epidemiological and clinical variables were analyzed using univariate and multivariate methods.
Main Results:
- The overall paediatric readmission rate was 4.1% (226 of 5,459 patients).
- Readmissions were significantly higher when hospital occupancy exceeded 70% (8.5% vs. 2.5%).
- Chronic disease and frequent emergency care visits were identified as predictive factors for preventable readmissions.
Conclusions:
- Increased paediatric readmissions correlate with periods of high hospital care pressure.
- Preventable readmissions, particularly in children with chronic conditions, necessitate targeted intervention strategies.
Introduction And Objectives:
Readmission rate is an indicator of the quality of hospital care. The aim of the study is to identify potential preventable factors for paediatric readmission.
Material And Methods:
A descriptive, analytical, longitudinal, and single centre study was carried out in the Paediatric Hospitalisation ward of a tertiary hospital during the period from June 2012 to November 2015. Readmission was defined as the one that occurs in the first 30 days of previous admission, as very early readmission if it occurs in the first 48hours, early readmission in the 2-7 days, and late readmission if occurs after 7 days. Preventable readmission is defined as one that takes place in the first 15 days and for the same reason as the first admission. Epidemiological and clinical variables were analysed. A univariate and multivariate study was carried out.
Results:
In the study period, 5,459 patients were admitted to the paediatric hospital, of which 226 of them were readmissions (rate of readmission: 4.1%). When the hospital occupation rate was greater than 70%, the overall percentage of readmissions was significantly higher (8.5% vs 2.5%; P<.001). In the multivariate analysis, it was found that having a chronic disease and the number of visits to emergency care units before admission, are predictive factors of preventable readmission.
Conclusions:
The rate of readmissions is greater in the periods of higher care pressure. The readmission of patients with chronic condition is preventable, and therefore strategies must be designed to try to avoid them.
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