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Healthcare Use in the Year Following Bronchiolitis Hospitalization
Jonathan H Pelletier1, Alicia K Au1,2,3,4, Dana Y Fuhrman1,2
1Departments of Critical Care Medicine.
Insights
Readmissions after infant bronchiolitis hospitalization are common, affecting 17.8% within a year. Outpatient healthcare use also increases significantly post-discharge, highlighting the need for ongoing care monitoring.
Area of Science:
- Pediatric Medicine
- Health Services Research
- Epidemiology
Background:
- Healthcare utilization patterns following bronchiolitis hospitalization in infants are not well-defined.
- Understanding readmission rates and outpatient visit frequency is crucial for managing post-hospitalization care.
Purpose of the Study:
- To characterize the rates of readmission and outpatient healthcare visits within one year after hospital discharge for bronchiolitis in young children.
- To identify factors associated with increased healthcare utilization after bronchiolitis hospitalization.
Main Methods:
- A retrospective, multicenter observational cohort study utilized the Pediatric Health Information Systems database.
- Data from January 2010 to December 2019 included over 300,000 bronchiolitis admissions in children under 24 months.
- A subset with linked electronic health records allowed for outpatient visit analysis.
Main Results:
- 17.8% of patients were readmitted within one year of bronchiolitis hospitalization.
- A median of 9 outpatient visits occurred per patient in the year post-discharge, with increased utilization for 4 months.
- Factors like ICU admission, mechanical ventilation, and complex chronic conditions were linked to higher readmission and outpatient use.
Conclusions:
- Readmissions are frequent in the year following infant bronchiolitis hospitalization.
- Outpatient healthcare utilization is elevated for several months post-discharge.
- Further prospective studies are recommended to assess the long-term outcomes for infants experiencing bronchiolitis.
Objectives:
Healthcare utilization after bronchiolitis hospitalization is incompletely understood. We aimed to characterize readmissions and outpatient visits within 1 year after hospital discharge.
Methods:
Retrospective multicenter observational cohort study of children under 24-months old admitted with bronchiolitis between January 1, 2010 and December 12, 2019 to the Pediatric Health Information Systems database. A single-center nested subset using linked electronic health records allowed analysis of outpatient visits.
Results:
There were 308 306 admissions for bronchiolitis among 271 115 patients across 47 hospitals between 2010-2019. The percent of patients readmitted within 30 days after discharge was 6.0% (16 167 of 271 115), and 17.8% (48 332 of 271 115) of patients were readmitted within 1 year. 22.9% (16 919 of 74 001) of patients admitted to an ICU and 26.8% (7865 of 29 378) of patients undergoing mechanical ventilation were readmitted within 1 year. There were 1438 patients with outpatient healthcare data available. There were a median (interquartile range) of 9 (6-13) outpatient visits per patient within 1 year after discharge. Outpatient healthcare use increased for 4 months following bronchiolitis hospitalization compared with previously reported age-matched controls. Higher income, white race, commercial insurance, complex chronic conditions, ICU admission, and mechanical ventilation were associated with higher outpatient utilization. Higher quartiles of outpatient use were associated with readmission for bronchiolitis and all-cause readmissions.
Conclusions:
Readmissions in the year after bronchiolitis hospitalization are common, and outpatient healthcare use is increased for 4 months following discharge. Prospective study is needed to track long-term outcomes of infants with bronchiolitis.
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