Performance of Pediatric Readmission Measures

Area of Science:

• Pediatric Quality Metrics
• Healthcare Readmission Analysis

Background:

• Hospital readmission rates are key quality indicators, but multiple pediatric measures exist.
• Current metrics may not accurately reflect preventable or unplanned pediatric readmissions.

Purpose of the Study:

• To compare four distinct pediatric readmission measures.
• To assess the accuracy of these measures in identifying preventable and unplanned readmissions.

Main Methods:

• Clinicians reviewed 1,125 pediatric 30-day readmissions (July 2014-June 2016).
• Readmissions were classified as preventable/not preventable and planned/unplanned.
• Sensitivity and specificity were calculated for four existing metrics against clinical review.

Main Results:

• Most readmissions (85%) were not preventable; only 15% were unplanned and preventable.
• No existing metric reliably identified preventable readmissions.
• The unplanned readmission/time flag metric demonstrated high sensitivity (95%) and specificity (90%) for unplanned readmissions.

Conclusions:

• Existing pediatric readmission measures lack reliability for assessing preventability.
• The unplanned readmission/time flag metric is the most effective for identifying unplanned pediatric readmissions.