Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2014 Jul;134(1):100-9.
doi: 10.1542/peds.2014-0331.

Readmissions among children previously hospitalized with pneumonia

Mark I Neuman  1 , Matthew Hall  2 , James C Gay  3 , Anne J Blaschke  4 , Derek J Williams  5 , Kavita Parikh  6 , Adam L Hersh  7 , Thomas V Brogan  8 , Jeffrey S Gerber  9 , Carlos G Grijalva  10 , Samir S Shah  11
Affiliations
Multicenter Study

Readmissions among children previously hospitalized with pneumonia

Mark I Neuman et al. Pediatrics. 2014 Jul.

Abstract

Background and objectives: Pneumonia is a leading cause of hospitalization and readmission in children. Understanding the patient characteristics associated with pneumonia readmissions is necessary to inform interventions to reduce avoidable hospitalizations and related costs. The objective of this study was to characterize readmission rates, and identify factors and costs associated with readmission among children previously hospitalized with pneumonia.

Methods: Retrospective cohort study of children hospitalized with pneumonia at the 43 hospitals included in the Pediatric Health Information System between January 1, 2008, and December 31, 2011. The primary outcome was all-cause readmission within 30 days after hospital discharge, and the secondary outcome was pneumonia-specific readmission. We used multivariable regression models to identify patient and hospital characteristics and costs associated with readmission.

Results: A total of 82 566 children were hospitalized with pneumonia (median age, 3 years; interquartile range 1-7). Thirty-day all-cause and pneumonia-specific readmission rates were 7.7% and 3.1%, respectively. Readmission rates were higher among children <1 year of age, as well as in patients with previous hospitalizations, longer index hospitalizations, and complicated pneumonia. Children with chronic medical conditions were more likely to experience all-cause (odds ratio 3.0; 95% confidence interval 2.8-3.2) and pneumonia-specific readmission (odds ratio 1.8; 95% confidence interval 1.7-2.0) compared with children without chronic medical conditions. The median cost of a readmission ($11 344) was higher than that of an index admission ($4495; P = .01). Readmissions occurred in 8% of pneumonia hospitalizations but accounted for 16.3% of total costs for all pneumonia hospitalizations.

Conclusions: Readmissions are common after hospitalization for pneumonia, especially among young children and those with chronic medical conditions, and are associated with substantial costs.

Keywords: pneumonia; readmission.

PubMed Disclaimer

Figures

FIGURE 1
FIGURE 1
All-cause and pneumonia-specific 30-day readmission rate by hospital. The total height of the bar represents the median hospital all-cause readmission rate.
FIGURE 2
FIGURE 2
Thirty-day readmissions by day (0–30) after hospitalization for pneumonia.
FIGURE 3
FIGURE 3
All-cause and pneumonia-specific 30-day readmission rate by chronic medical condition.
See this image and copyright information in PMC

References

    1. Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009;360(14):1418–1428 - PubMed
    1. Joynt KE, Jha AK. Characteristics of hospitals receiving penalties under the Hospital Readmissions Reduction Program. JAMA. 2013;309(4):342–343 - PubMed
    1. Berry JG, Toomey SL, Zaslavsky AM, et al. . Pediatric readmission prevalence and variability across hospitals [published correction appears in JAMA. 2013;309(10):986]. JAMA. 2013;309(4):372–380 - PMC - PubMed
    1. Berry JG, Hall DE, Kuo DZ, et al. . Hospital utilization and characteristics of patients experiencing recurrent readmissions within children’s hospitals. JAMA. 2011;305(7):682–690 - PMC - PubMed
    1. Brogan TV, Hall M, Williams DJ, et al. . Variability in processes of care and outcomes among children hospitalized with community-acquired pneumonia. Pediatr Infect Dis J. 2012;31(10):1036–1041 - PMC - PubMed

Publication types