Risk factors for hospital readmission within 30 days: a new quality measure for children with sickle cell disease. Pediatr Blood Cancer 2009 Apr;52(4):481-5
Date
12/06/2008Pubmed ID
19058209Pubmed Central ID
PMC2730199DOI
10.1002/pbc.21854Scopus ID
2-s2.0-62449189504 (requires institutional sign-in at Scopus site) 75 CitationsAbstract
BACKGROUND: The National Association of Children's Hospitals and Related Institutions (NACHRI) established hospital readmission within 30 days as a benchmark for quality care in children with Sickle Cell Disease (SCD). Among children with SCD, limited data exists to identify risk factors for readmission and whether they are modifiable.
PROCEDURE: We performed a retrospective cohort study to identify risk factors for readmission. All admissions for children with SCD in a 1-year period were reviewed; cases were defined as children with SCD readmitted within 30 days after their first admission during the study period and controls, children with SCD who were not readmitted.
RESULTS: We identified 30 cases and 70 controls. No difference in demographic data was found between groups. The most common admission and readmission diagnosis was pain, 78 and 70%, respectively. The greatest risk factor for readmission was no outpatient hematology follow-up within 30 days of discharge (OR 7.7, 95% CI 2.4-24.4). A diagnosis of asthma was also a risk factor for readmission (OR 2.9, 95% CI 1.2-7.3). Patients who required supplemental oxygen to maintain saturations in the normal range and were on room air for < or =24 hr at discharge were also more likely to be readmitted (OR 3.3, 95% CI 1.1-9.7). Multivariate analysis identified lack of outpatient follow-up and disease severity, defined as > or =3 admissions in the previous 12 months as predictors for readmission (R(2) = 0.41).
CONCLUSIONS: Potentially modifiable risk factors exist to decrease the rate of readmission of children with SCD admitted to the hospital for pain.
Author List
Frei-Jones MJ, Field JJ, DeBaun MRAuthor
Joshua J. Field MD Professor in the Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdolescentAdult
Anemia, Sickle Cell
Child
Child, Preschool
Cohort Studies
Female
Humans
Infant
Length of Stay
Male
Patient Readmission
Quality of Health Care
Retrospective Studies
Risk Factors
