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. 2024 Apr-Jun;12(2):134-144.
doi: 10.4103/sjmms.sjmms_352_23. Epub 2024 Apr 5.

Unplanned Readmissions in Children with Medical Complexity in Saudi Arabia: A Large Multicenter Study

Futoon Alotaibi  1   2   3 , Hamad Alkhalaf  1   2   3 , Hissah Alshalawi  1 , Hadeel Almijlad  1 , Abdulaziz Ureeg  3 , Suliman Alghnam  4
Affiliations

Unplanned Readmissions in Children with Medical Complexity in Saudi Arabia: A Large Multicenter Study

Futoon Alotaibi et al. Saudi J Med Med Sci. 2024 Apr-Jun.

Abstract

Background: Children with medical complexity (CMC) account for a substantial proportion of healthcare spending, and one-third of their expenditures are due to readmissions. However, knowledge regarding the healthcare-resource utilization and characteristics of CMC in Saudi Arabia is limited.

Objectives: To describe hospitalization patterns and characteristics of Saudi CMC with an unplanned 30-day readmission.

Methodology: This retrospective study included Saudi CMC (aged 0-14 years) who had an unplanned 30-day readmission at six tertiary centers in Riyadh, Jeddah, Dammam, Alahsa, and Almadina between January 2016 and December 2020. Hospital-based inclusion criteria focused on CMC with multiple complex chronic conditions (CCCs) and technology assistance (TA) device use. CMC were compared across demographics, clinical characteristics, and hospital-resource utilization.

Results: A total of 9139 pediatric patients had unplanned 30-day readmission during the study period, of which 680 (7.4%) met the inclusion criteria. Genetic conditions were the most predominant primary pathology (66.3%), with one-third of cases (33.7%) involving the neuromuscular system. During the index admission, pneumonia was the most common diagnosis (33.1%). Approximately 35.1% of the readmissions were after 2 weeks. Pneumonia accounted for 32.5% of the readmissions. After readmission, 16.9% of patients were diagnosed with another CCC or received a new TA device, and the in-hospital mortality rate was 6.6%.

Conclusion: The rate of unplanned 30-day readmissions in children with medical complexity in Saudi Arabia is 7.4%, which is lower than those reported from developed countries. Saudi children with CCCs and TA devices were readmitted approximately within similar post-discharge time and showed distinct hospitalization patterns associated with specific diagnoses. To effectively reduce the risk of 30-day readmissions, targeted measures must be introduced both during the hospitalization period and after discharge.

Keywords: Child; Saudi Arabia; children with medical complexity; chronic illness; complex chronic conditions; mortality; patient readmission; pneumonia; technology assistance.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Flowchart of patient screening process
Figure 2
Figure 2
Percentages of main system involved per region
See this image and copyright information in PMC

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References

    1. Cohen E, Kuo DZ, Agrawal R, Berry JG, Bhagat SK, Simon TD, et al. Children with medical complexity: An emerging population for clinical and research initiatives. Pediatrics. 2011;127:529–38. - PMC - PubMed
    1. Berry JG, Hall M, Neff J, Goodman D, Cohen E, Agrawal R, et al. Children with medical complexity and Medicaid: Spending and cost savings. Health Aff (Millwood) 2014;33:2199–206. - PMC - PubMed
    1. Temsah MH, Abouammoh N, Al Eyadhy A, AlRuthia Y, Hassounah M, Alsohime F, et al. Predictors and direct cost estimation of long stays in pediatric intensive care units in Saudi Arabia: A mixed methods study. Risk Manag Healthc Policy. 2021;14:2625–36. - PMC - PubMed
    1. AlKhalaf H, AlHamdan W, Kinani S, AlZighaibi R, Fallata S, Al Mutrafy A, et al. Identifying the prevalence and causes of 30-day hospital readmission in children: A case study from a tertiary pediatric hospital. Glob J Qual Saf Healthc. 2023;6:101–10. - PMC - PubMed
    1. Cohen E, Berry JG, Camacho X, Anderson G, Wodchis W, Guttmann A. Patterns and costs of health care use of children with medical complexity. Pediatrics. 2012;130:e1463–70. - PMC - PubMed

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