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Progress (?) Toward Reducing Pediatric Readmissions.

Katherine A Auger1, J Mitchell Harris2, James C Gay3

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Pediatric readmission rates did not change over six years, despite hospital efforts to reduce them. Both all-cause (AC) and potentially preventable readmission (PPR) rates remained stable, indicating a need for new strategies.

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Area of Science:

  • Pediatric Healthcare
  • Health Services Research
  • Quality Improvement

Background:

  • Children's hospitals aim to decrease readmissions for better patient outcomes and to avoid financial penalties.
  • Previous initiatives have focused on reducing pediatric readmissions, but their long-term impact is unclear.

Purpose of the Study:

  • To analyze trends in pediatric readmission rates over a six-year period.
  • To determine if national efforts to reduce readmissions have been effective.

Main Methods:

  • Utilized data from 66 children's hospitals within the Inpatient Essentials Database (January 2010 - June 2016).
  • Calculated seven-day all-cause (AC) and potentially preventable readmission (PPR) rates using 3M PPR software.
  • Analyzed aggregate and condition-specific quarterly readmission rates for 4.52 million hospitalizations.

Main Results:

  • Pediatric readmission rates showed no significant change over the study period.
  • The median seven-day PPR rate was consistently around 2.5% (range 2.1%-2.5%).
  • The median seven-day AC rate remained stable at approximately 5.1% (range 4.3%-5.3%), though condition-specific rates fluctuated.

Conclusions:

  • Despite substantial national efforts, pediatric all-cause and potentially preventable readmission rates have remained unchanged over six years.
  • Current strategies may not be sufficient to reduce pediatric readmissions.
  • Further research into novel approaches is warranted to improve pediatric readmission rates.