Demographic Factors Associated With Bronchiolitis Readmission

Author:

Riese Jeffrey1,McCulloh Russell J.1,Koehn Kristin L.2,Alverson Brian K.1

Affiliation:

1. Department of Pediatrics, Rhode Island Hospital/Hasbro Children’s Hospital, Providence, Rhode Island; and

2. University of Missouri, Women’s and Children’s Hospital, Columbia, Missouri

Abstract

Objectives: The goal of this study was to evaluate patient characteristics and medical management and their association with readmission in children with bronchiolitis. Methods: This retrospective chart review included children admitted with bronchiolitis to 2 children’s hospitals. Reviewers selected charts based on International Classification of Diseases, Ninth Revision, diagnosis and collected information on demographic characteristics, treatment, diagnostic testing, length of stay, and adverse outcomes. Univariate analyses were used to identify risk factors associated with any-cause readmission in 4 weeks. Results: A total of 1229 patients met inclusion criteria. Younger children were more likely to be readmitted within 4 weeks of discharge compared with older children (mean age: 4.5 vs 5.7 months; P = .005). Readmissions did not differ based on length of stay, and no medical intervention was associated with risk for readmission. Of patients readmitted from the large service area hospital, 57% lived ≤20 miles away, compared with 26.9% of those who were not readmitted (P = .03). Patients from the lowest income zip codes within the catchment area of the small service area hospital were more likely to be readmitted compared with patients from the highest income zip codes (7.8% vs 0%; P = .025). Conclusions: Overall, 6.4% of hospitalized patients with bronchiolitis were readmitted. Our data did not identify any inpatient medical management or modifiable risk factor associated with readmission.

Publisher

American Academy of Pediatrics (AAP)

Subject

Pediatrics,General Medicine,Pediatrics, Perinatology, and Child Health

Reference16 articles.

1. Rehospitalizations among patients in the Medicare fee-for-service program;Jencks;N Engl J Med,2009

2. Pediatric readmission prevalence and variability across hospitals [published correction in JAMA. 2013;309(10):986]..;Berry;JAMA,2013

3. Centers for Medicare & Medicaid Services. Readmissions reduction program. Available from: www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/AcuteInpatientPPS/Readmissions-Reduction-Program.html. Accessed January 5, 2014.

4. Direct medical costs of bronchiolitis hospitalizations in the United States;Pelletier;Pediatrics,2006

5. Hospital utilization and characteristics of patients experiencing recurrent readmissions within children’s hospitals;Berry;JAMA,2011

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