Rates and Factors Associated With Short Stay Admissions and Readmissions Among Children and Youth With Complex...

Area of Science:

• Pediatric healthcare research
• Health services research
• Chronic disease management

Background:

• Complex chronic conditions (CCCs) in children contribute to frequent hospitalizations.
• Short stay admissions (SSAs) are a significant component of pediatric healthcare utilization.
• Understanding factors influencing SSAs and readmissions is crucial for optimizing care.

Purpose of the Study:

• To determine the rates and variability of SSAs in children with CCCs.
• To identify factors associated with SSAs and subsequent 7-day hospital readmissions.
• To explore the potential of SSAs as a target for preventing unnecessary hospitalizations.

Main Methods:

• Retrospective analysis of over 1.2 million pediatric admissions across 47 children's hospitals.
• Inclusion criteria: children with >1 CCC and admissions ≤1 day.
• Multivariate analysis examined risk factors including demographics, clinical factors, Child Opportunity Index (COI), and ambulatory care sensitive conditions (ACSCs).

Main Results:

• SSAs constituted 23.3% of admissions for children with >1 CCC, with significant hospital-level variation (17.1-29.9%).
• Higher odds of SSA were linked to high COI, single CCC, and admission for ACSCs.
• The 7-day readmission rate post-SSA was 5.8%, with higher odds associated with multiple CCCs and prior ICU admission.

Conclusions:

• SSAs are prevalent, accounting for nearly 25% of admissions for children with CCCs.
• 7-day readmission rates following SSAs are relatively low.
• SSAs may present opportunities for intervention to prevent avoidable hospitalizations in this vulnerable population.