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30-day readmission rate in pediatric otorhinolaryngology inpatients: a retrospective population-based cohort study
Katharina Geißler1, Wido Rippe2, Daniel Boeger3
1Department of Otorhinolaryngology, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany. Katharina.Geissler@med.uni-jena.de.
Insights
Pediatric otolaryngology patients had a lower 30-day readmission rate than adults, with unplanned readmissions being more common in children. Postoperative bleeding and infections were primary reasons for pediatric readmissions.
Area of Science:
- Otolaryngology
- Pediatric Healthcare
- Health Services Research
Background:
- 30-day readmissions are a key indicator of healthcare quality.
- Understanding readmission patterns in pediatric otolaryngology is crucial for improving patient outcomes.
- The German Diagnosis Related Group (G-DRG) system provides valuable data for analyzing healthcare utilization.
Purpose of the Study:
- To analyze the frequency and reasons for planned and unplanned 30-day readmissions in pediatric otorhinolaryngology patients.
- To compare readmission rates and patterns between pediatric and adult patients.
- To identify specific diagnoses and complications leading to readmission in children.
Main Methods:
- Retrospective population-based cohort study using German Diagnosis Related Group (G-DRG) data from Thuringia, Germany, for 2015.
- Inclusion of 2440 pediatric cases (under 18 years) within the otorhinolaryngology specialty.
- Analysis of diagnoses, readmission rates, reasons for readmission, and comparison with adult patient data.
Main Results:
- A 30-day readmission rate of 1.5% (36 cases) was observed in pediatric patients.
- Unplanned readmissions constituted 75% of all pediatric readmissions, with a median interval of 8 days.
- The most frequent reasons for readmission were postoperative bleeding (33.4%) and infectious complications (36.2%), particularly following adenoidectomy and tonsillectomy.
Conclusions:
- The 30-day readmission rate in pediatric otolaryngology appears lower than in adult patients.
- Unplanned readmissions are predominant in pediatric cases, contrasting with the higher rate of planned readmissions in adults.
- Key drivers for pediatric readmissions include surgical complications like bleeding and infections, necessitating targeted preventative strategies.
Objectives:
Analysis of frequency and reasons for planned and unplanned 30-day readmission in hospitalized pediatric otorhinolaryngology patients using German Diagnosis Related Group (G-DRG) system data.
Methods:
A retrospective population-based cohort study in Thuringia, Germany, was performed for the year 2015 with 2440 cases under 18 years (55.6% male) out of a total number of 15.271 inpatient cases. The majority of pediatric patients were from 2 to 5 years old (54.5%). The most frequent diagnoses were hyperplasia of adenoids or/and tonsils (26.6%). 36 cases (1.5%) experienced readmission within 30-days.
Results:
30-day readmission was planned in 9 cases (25% of all readmission) and was unplanned in 27 cases (75%). The median interval between index and readmission treatment was 8 days. Postoperative bleeding after adenoidectomy, tonsillotomy/tonsillectomy or tracheostomy (33.4%) and infectious complications after surgery like acute otitis media, abscess formation or fever (36.2%) were the most frequent reasons for 30-day readmission. Compared to adults treated in 2015 in Thuringia, the readmission rate was higher in adult patients (8.9%) than in this pediatric cohort. In contrast to children, readmissions in adults were mainly planned (65.1%) with a different spectrum of underlying diseases and reasons for readmission.
Conclusion:
The 30-day readmission rate seemed to be lower for pediatric otolaryngology patients compared to adult patients. Unplanned readmissions dominated in pediatric patients, whereas planned readmissions dominated in adults.
