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. 2019 Feb;143(2):e20181958.
doi: 10.1542/peds.2018-1958.

Trends in Pediatric Hospitalizations and Readmissions: 2010-2016

Emily M Bucholz  1   2 , Sara L Toomey  2   3 , Mark A Schuster  4   3   5
Affiliations

Trends in Pediatric Hospitalizations and Readmissions: 2010-2016

Emily M Bucholz et al. Pediatrics. 2019 Feb.

Abstract

Background: Health reform and policy initiatives over the last 2 decades have led to significant changes in pediatric clinical practice. However, little is known about recent trends in pediatric hospitalizations and readmissions at a national level.

Methods: Data from the 2010-2016 Healthcare Cost and Utilization Project Nationwide Readmissions Database and National Inpatient Sample were analyzed to characterize patient-level and hospital-level trends in annual pediatric (ages 1-17 years) admissions and 30-day readmissions. Poisson regression was used to evaluate trends in pediatric readmissions over time.

Results: From 2010 to 2016, the total number of index admissions decreased by 21.3%, but the percentage of admissions for children with complex chronic conditions increased by 5.7%. Unadjusted pediatric 30-day readmission rates increased over time from 6.26% in 2010 to 7.02% in 2016 with a corresponding increase in numbers of admissions for patients with complex chronic conditions. When stratified by complex or chronic conditions, readmission rates declined or remained stable across patient subgroups. Mean risk-adjusted hospital readmission rates increased over time overall (6.46% in 2010 to 7.14% in 2016) and in most hospital subgroups but decreased over time in metropolitan teaching hospitals.

Conclusions: Pediatric admissions declined from 2010 to 2016 as 30-day readmission rates increased. The increase in readmission rates was associated with greater numbers of admissions for children with chronic conditions. Hospitals serving pediatric patients need to account for the rising complexity of pediatric admissions and develop strategies for reducing readmissions in this high-risk population.

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Conflict of interest statement

POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Patient-level unadjusted readmission rates stratified by (A) sex, (B) age, and (C) presence of a chronic or complex condition defined by the PMCA.
FIGURE 2
FIGURE 2
Hospital-level risk-adjusted readmission rates stratified by (A) number of pediatric admissions, (B) hospital ownership, and (C) hospital teaching status.
See this image and copyright information in PMC

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