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COVID-19 and Unplanned Paediatric Hospital Readmissions in Australia: A Retrospective Cohort Study
Huma Sadulla1, Adhya Miriam Tom2, Gary Low3,4
1School of Medicine, Western Sydney University, Sydney, NSW 2560, Australia.
Insights
The COVID-19 pandemic saw a decrease in unplanned paediatric hospital readmissions in Australia, particularly for First Nations children. Higher readmission rates persisted for male infants and those from advantaged areas, indicating a need for targeted interventions.
Area of Science:
- Paediatric Healthcare Quality
- Epidemiology
- Health Services Research
Background:
- Unplanned paediatric readmissions are critical indicators of healthcare quality and discharge planning effectiveness.
- The COVID-19 pandemic profoundly impacted healthcare delivery, necessitating an examination of its effects on paediatric readmission patterns in Australia.
Purpose of the Study:
- To investigate the impact of the COVID-19 pandemic on unplanned paediatric hospital readmission rates.
- To identify trends and patient characteristics associated with paediatric readmissions before and during the pandemic.
Main Methods:
- A 5-year retrospective cohort study analyzed 21,262 paediatric admissions and readmissions at an Australian hospital.
- Data were classified into pre-pandemic (before March 2020) and pandemic (after March 2020) periods.
- Patient demographics, diagnoses, and socio-economic status were examined to identify readmission trends.
Main Results:
- Paediatric admissions decreased by nearly 30% during the pandemic, with readmission rates falling from 7.5% to 4.6%.
- Higher readmission rates were observed in male patients, infants aged 0-12 months, and children from socio-economically advantaged areas.
- Readmissions declined for First Nations children and those with communicable diseases during the pandemic.
Conclusions:
- Male infants and those under 12 months consistently showed higher readmission rates.
- Findings underscore the need for targeted early interventions, age-specific discharge planning, and enhanced follow-up for high-risk paediatric populations.
- Further research with extended periods and larger cohorts is recommended for generalisability and long-term trend analysis.
Abstract:
Background: Unplanned paediatric hospital readmissions are key indicators of healthcare quality, often reflecting issues in discharge planning and continuity of care. The COVID-19 pandemic significantly disrupted healthcare delivery and utilisation, yet its impact on paediatric readmission patterns in Australia remains unclear. Methods: A 5-year single-centre retrospective cohort study of 21,262 paediatric admissions and unplanned readmissions at a non-tertiary metropolitan Australian hospital between 21 March 2017 and 20 March 2023 was conducted. Admissions up to 20 March 2020 were classified as pre-pandemic, and those from 21 March 2020 as during the COVID-19 pandemic. We analysed patient characteristics, including gender, age, First Nations status, primary diagnosis, and socio-economic status, to identify UHR trends. Results: During the COVID-19 period, total paediatric admissions declined by nearly 30%, and the readmission rate decreased from 7.5% to 4.6% compared with the pre-pandemic period. Across both cohorts, higher readmission rates were observed among male patients, infants aged 0-12 months, and children from more socio-economically advantaged areas. Readmissions among First Nations children and those with communicable diseases declined during the pandemic period. Conclusions: A higher proportion of males and patients under 12 months of age had higher readmission rates across both periods. These findings highlight the need for targeted early intervention, age-specific discharge planning, and strengthened follow-up care for high-risk groups. Further research should extend the study period beyond the pandemic and include larger cohorts to better characterise long-term trends and improve generalisability.
