Affiliation:
1. Department of Pediatric Medicine, All Children’s Hospital, Johns Hopkins Medicine, St Petersburg, Florida;
2. Department of Pediatrics, Joe DiMaggio Hospital, Fort Lauderdale, Florida; and
3. Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland
Abstract
OBJECTIVE:
To assess the causes and preventability of pediatric readmissions from the perspectives of parents and their physicians to guide future interventions.
METHODS:
Parent interview, physician survey, and medical record review were completed for children who were readmitted to a pediatric hospitalist service within 30 days of an index admission. Questions were asked about Health Belief Model constructs (perceived severity, susceptibility or preventability of admission, and perceived barriers), discharge readiness, and follow-up plans. Parent and physician perceptions about reasons for readmissions were examined, and responses to open-ended questions were coded.
RESULTS:
60 parent–physician pairs completed the study. The mean age of the patients was 6.43 (SD 6.42) years; 45% (n = 27) had a chronic disease, and 47% (n = 28) of patients were readmitted with the same or similar condition as in the previous hospitalization. At readmission, parents were more likely than physicians to think that the condition was serious (parent 98%, physician 76%; P < .001) and that the readmission could have been prevented (parent 59%, physician 36%; P = .04). Most parents (63%) and physicians (65%) thought it was likely that the child may have future hospitalizations. Opportunities to prevent readmission included need for parent education, improving medication access and adherence, and need for coordination of follow-up care.
CONCLUSIONS:
Many parents and physicians thought the readmission was preventable, and the majority of both thought that the patient was susceptible to another hospitalization. Parents and physicians suggest opportunities to improve care processes during hospitalization and in services provided after discharge to reduce readmissions.
Publisher
American Academy of Pediatrics (AAP)
Subject
Pediatrics,General Medicine,Pediatrics, Perinatology and Child Health
Reference29 articles.
1. Hospital readmission as an accountability measure;Axon;JAMA,2011
2. Early readmissions to the department of medicine as a screening tool for monitoring quality of care problems;Balla;Medicine (Baltimore),2008
3. Rehospitalizations among patients in the Medicare fee-for-service program;Jencks;N Engl J Med,2009
4. Centers for Medicare and Medicaid Services. Readmissions Reduction Program. Available at: www.medicare.gov/hospitalcompare/Data/30-day-measures.html?AspxAutoDetectCookieSupport=1. Accessed July 1, 2015
5. Agency for Healthcare Research and Quality. Chipra Measures by CHIPRA Categories. Available at: www.ahrq.gov/policymakers/chipra/pqmpmeasures.html. Accessed March 10, 2013
Cited by
21 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献