Epidemiology of 15-Day Readmissions to a Children's Hospital

Abstract

OBJECTIVE: To describe the population of pediatric patients readmitted to a children's hospital within 15 days of discharge. PATIENTS AND METHODS: Medical records were reviewed to identify characteristics of patients and their hospitalizations for all children hospitalized during calendar years 2007–2008 who were readmitted up to and including 15 days after a previous discharge. RESULTS: Of 30 188 total hospital admissions during the study period, 2546 (8.4%) were followed by a readmission within 15 days of discharge. The age groups with the greatest number of readmissions were infants (aged 31–364 days, 20.8% of readmissions) and patients aged >10 years (31.3% of readmissions). Most readmitted patients (78.0%) had an underlying chronic illness, and patients with malignancies were most likely to be readmitted, followed by newborns and patients with neurologic conditions. Patients with malignancies also experienced the greatest number of readmissions per patient (4.1). Most patients who were readmitted had only 1 readmission (71.5%), but the small subset of patients with 3 or more readmissions accounted for 43.7% of all 15-day readmissions. Disease recurrence and natural course of the original diagnosis were the most common reasons for readmission (44.9%), followed by planned readmissions (20.6%) and readmissions for a new, unrelated illness (7.7%). CONCLUSIONS: This report is the first description of the epidemiology of all 15-day pediatric readmissions at a children's hospital. The results of this study serve as a basis for additional analysis to determine the extent to which readmissions in the pediatric population may or may not be preventable.