Readmission rates varied substantially at children’s hospitals

The overall rate of readmissions at 72 pediatric hospitals hovered around 6.5%, with substantial variation in readmission rates across hospitals in a recently published study. Further data are needed to determine how care might be different in hospitals with high vs. low readmission rates, according to study results and an accompanying editorial published online.

Jay G. Berry, MD, MPH, of the division of general pediatrics at Boston Children’s Hospital, and colleagues conducted a study to examine the percentage of hospitalized children who have unplanned readmissions, which admission diagnoses have the most readmissions, and whether readmission rates vary across hospitals. The analysis included data from 568,845 admissions at 72 children’s hospitals between July 2009 and June 2010 in the National Association of Children’s Hospitals and Related Institutions Case Mix Comparative data set.

Jay G. Berry

Berry and colleagues said the 30-day readmission rate was 6.5% (n=36,734) among readmitted children, and of these, 39% were readmitted in the first 7 days; 61% were readmitted in the first 14 days.

“Not all readmissions are bad. Some are completely appropriate,” Berry told Infectious Diseases in Children. “Still, we want to know whether there is something that hospitals and systems with low readmission rates are doing to more effectively transition their children home.”

For each condition-specific admission, 27.3% to 86.2% of readmissions were for a diagnosis involving the same organ system or a related etiology as the index admission. Sickle cell had the highest percentage of readmissions (79.4%) that were for the same diagnosis as the index admission.

In an accompanying editorial, Rajendu Srivastava, MD, of the University of Utah Health Sciences Center, Salt Lake City, and Ron Keren, MD, MPH, of the University of Pennsylvania School of Medicine, Philadelphia, said: “Research needs to better determine how many readmissions are due to poor hospital quality of care vs. other reasons for readmissions and how many are preventable.”

For more information:

Srivastava R. JAMA. 2013;309:396-398.

Jay G.Berry, MD, MPH, can be reached at the Division of General Pediatrics, Boston Children’s Hospital, Harvard Medical School, 300 Longwood Ave, Boston, MA 02115; email: jay.berry@childrens.harvard.edu.

Disclosure: Berry was supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.