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Thirty-day readmissions in children with complex chronic conditions
Daiana Basso1, Carolina Bermúdez1, Vanessa Carpio1
1Hospital General de Niños Pedro de Elizalde, Ciudad Autónoma de Buenos Aires, Argentina.
Insights
High 30-day hospital readmission rates (16.4%) were observed in paediatric patients with complex chronic conditions. Most readmissions (82.1%) were preventable, with respiratory disease being a key risk factor.
Area of Science:
- Healthcare Quality Improvement
- Paediatric Complex Chronic Conditions
- Hospital Readmission Research
Background:
- 30-day hospital readmission is a critical healthcare quality indicator.
- Paediatric patients with complex chronic conditions exhibit elevated readmission rates.
- Suboptimal hospital-to-home care transitions may contribute to readmissions.
Purpose of the Study:
- To determine the incidence of 30-day readmissions in paediatric complex chronic conditions.
- To assess the proportion of potentially preventable readmissions.
- To identify factors associated with readmission in this population.
Main Methods:
- A cohort study design was employed.
- Included were hospitalised patients aged 1 month to 18 years with complex chronic conditions (excluding cancer and surgical congenital heart disease).
- Data analysed included sociodemographic, geographic, clinical, and home care transition characteristics.
Main Results:
- The study encompassed 171 hospitalizations, with 28 patients (16.4%) readmitted within 30 days.
- A significant majority of readmissions, 23 (82.1%), were deemed potentially preventable.
- Respiratory disease was identified as a factor associated with increased readmission probability.
Conclusions:
- The 30-day readmission rate for paediatric complex chronic conditions stands at 16.4%.
- A substantial 82.1% of these readmissions were potentially preventable.
- Respiratory disease emerged as the sole identified risk factor for 30-day readmission in this cohort.
Introduction:
The rate of hospital readmission within 30 days of discharge is a quality indicator in health care. Paediatric patients with complex chronic conditions have high readmission rates. Failure in the transition between hospital and home care could explain this phenomenon.
Objectives:
To estimate the incidence rate of 30-day hospital readmission in paediatric patients with complex chronic conditions, estimate how many are potentially preventable and explore factors associated with readmission.
Materials And Method:
Cohort study including hospitalised patients with complex chronic conditions aged 1 month to 18 years. Patients with cancer or with congenital heart disease requiring surgical correction were excluded. The outcomes assessed were 30-day readmission rate and potentially preventable readmissions. We analysed sociodemographic, geographic, clinical and transition to home care characteristics as factors potentially associated with readmission.
Results:
The study included 171 hospitalizations, and 28 patients were readmitted within 30 days (16.4%; 95% CI, 11.6%-22.7%). Of the 28 readmissions, 23 were potentially preventable (82.1%; 95% CI, 64.4%-92.1%). Respiratory disease was associated with a higher probability of readmission. There was no association between 30-day readmission and the characteristics of the transition to home care.
Conclusions:
The 30-day readmission rate in patients with complex chronic disease was 16.4%, and 82.1% of readmissions were potentially preventable. Respiratory disease was the only identified risk factor for 30-day readmission.
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