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Readmissions common in young children hospitalized with pneumonia
VANCOUVER, British Columbia — Children hospitalized with pneumonia often require readmission, especially among young children and those with chronic medical conditions, and the associated costs are significant, according to findings presented here.
“Understanding the patient characteristics associated with pneumonia readmissions is necessary to inform interventions to reduce avoidable hospitalizations and related costs,” Mark I. Neuman, MD, specialist in emergency medicine and assistant professor in pediatrics, Boston Children’s Hospital, said during his presentation at the 2014 Pediatric Academic Societies Annual Meeting.
Mark I. Neuman
Neuman and colleagues conducted a retrospective cohort study of children hospitalized with pneumonia to characterize readmission rates within 30 days following hospital discharge, and identify factors and costs associated with readmission for children hospitalized with pneumonia.
The investigators analyzed data from 43 hospitals in the Pediatric Health Information System between 2008 and 2011. The primary outcome was readmission for any reason (all-cause readmission) within 30 days following pneumonia hospitalization. The secondary outcome was pneumonia-specific readmission, defined as a readmission with an ICD-9 diagnosis code for pneumonia.
A total of 82,566 children were hospitalized with pneumonia (median age, 3 years; Interquartile range, 1-7). All-cause and pneumonia-specific readmission rates were 7.7% and 3.1%, respectively.
Rates of readmission were highest for patients aged younger than 1 year, those with prior hospitalizations, longer index hospitalizations, and complicated pneumonia, according to Neuman.
Patients with chronic conditions were more likely to experience all-cause (OR=3.0; 95% CI 2.8, 3.2) and pneumonia-specific readmission (OR= 1.8; 95% CI 1.7, 2.0) compared with patients without chronic conditions.
The median cost of a readmission was higher than for an index admission ($11,344 vs. $4,495, respectively; P=.01). Although readmissions occurred in about 8% of pneumonia hospitalizations, Neuman said that readmissions accounted for 16.3% ($163 million) of total costs (index and readmission costs combined) for pneumonia hospitalizations ($1 billion) during the study period.
“Readmissions are common after hospitalization for pneumonia, especially among young children and those with chronic medical conditions. The costs associated with pneumonia readmissions are substantial,” Neuman concluded. — by Cassandra A. Richards
For more information:
Neuman MI. Abstract 3385.3. Presented at PAS 2014; May 2-6, 2014; Vancouver, Canada.
Disclosure: Neuman reports no relevant financial disclosures.