Association of Extending Hospital Length of Stay With Reduced Pediatric Hospital Readmissions

Abstract

This cohort study explores the association between index hospitalization length of stay and hospital readmissions among children.

Figure.. Aggregate Number of Additional Bed-Days Needed Across Index Hospitalizations to Avoid 1 Pediatric Hospital Readmission Among US Children

After generating the model associating hospital-level adjusted mean length of stay (LOS) with adjusted readmission rate for each All Patient Refined Diagnosis Related Group (APR-DRG), β coefficients from the regression equation were used to estimate the number of additional bed-days needed to avoid 1 pediatric hospital readmission. The β coefficient provided an estimate for the change in the readmission rate for a 1-day increase in mean LOS. Thus, the change in the number of readmissions was estimated as follows: (No. of Observed Readmissions) − (Observed Readmission Rate + β) × No. of Cases. Then the number of days needed to avoid 1 readmission was estimated as follows: (No. of Additional Days)/(Change in the No. of Readmissions), where the number of additional days was equal to the number of cases because 1 day was added to the LOS of each case. Additional costs associated with additional hospital bed-days were determined by multiplying the number of days needed to avoid 1 readmission by the median cost per day for the APR-DRG. For example, for asthma, 81.8 additional days were required to prevent 1 readmission, with a cost per day of $2502 (or $204 638 for 81.8 additional bed-days).