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Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
Published on: April 12, 2021
Clinical and Social Risk Factors for 30-Day Readmissions in Children With Kidney Disease
Leonela Villegas1, Rui Xiao2, Lilia Cervantes3
1Division of Pediatric Nephrology, Connecticut Children's Medical Center, Hartford, Connecticut; Division of Pediatric Nephrology, Children's Hospital of Philadelphia.
Summary
Hospital readmissions are common in pediatric chronic kidney disease (CKD), affecting 12.8% of patients. Clinical complexity and mental health issues are key drivers, necessitating targeted interventions to reduce readmissions.
Area of Science:
- Pediatric Nephrology
- Healthcare Outcomes Research
- Public Health
Background:
- Hospital readmissions pose a significant burden in pediatric chronic kidney disease (CKD).
- The epidemiology and contributing factors to readmission in this population are not well understood.
- Understanding these factors is crucial for improving care and reducing healthcare costs.
Purpose of the Study:
- To evaluate 30-day all-cause readmission rates in U.S. pediatric patients with CKD.
- To identify clinical and social factors associated with these readmissions.
- To inform strategies for reducing preventable hospitalizations.
Main Methods:
- Retrospective cohort study utilizing data from the Pediatric Health Information System (PHIS).
- Included children aged ≤18 years diagnosed with CKD between January 2016 and June 2021.
- Multivariable logistic regression analysis was performed to identify predictors of readmission.
Main Results:
- 12.8% of pediatric CKD patients (n=48,228) experienced 30-day readmission; 22.3% of those with kidney failure were readmitted.
- Factors associated with increased readmission risk included glomerular CKD etiology, complex chronic disease, higher illness severity, longer length of stay, and mental health comorbidity.
- Urban residence was linked to higher readmission, while insurance type, neighborhood income, and Child Opportunity Index were not significant predictors.
Conclusions:
- Nearly 1 in 8 children with CKD and 1 in 5 with kidney failure are readmitted within 30 days.
- Readmission risk is primarily driven by clinical complexity, illness severity, and mental health comorbidities.
- Findings support the development of integrated transitional care and targeted interventions for medical and behavioral health needs to minimize hospital utilization.
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