Readmissions among children previously hospitalized with pneumonia
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 r...
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| Veröffentlicht in: | Pediatrics (Evanston) 2014-07, Vol.134 (1), p.100-109 |
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| creator | Neuman, Mark I Hall, Matthew Gay, James C Blaschke, Anne J Williams, Derek J Parikh, Kavita Hersh, Adam L Brogan, Thomas V Gerber, Jeffrey S Grijalva, Carlos G Shah, Samir S |
| description | 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.
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.
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 |
| doi_str_mv | 10.1542/peds.2014-0331 |
| format | Article |
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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.
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.
Readmissions are common after hospitalization for pneumonia, especially among young children and those with chronic medical conditions, and are associated with substantial costs.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.2014-0331</identifier><identifier>PMID: 24958590</identifier><identifier>CODEN: PEDIAU</identifier><language>eng</language><publisher>United States: American Academy of Pediatrics</publisher><subject>Admission and discharge ; Bacterial pneumonia ; Care and treatment ; Child ; Child, Preschool ; Children & youth ; Cohort Studies ; Confidence intervals ; Costs and Cost Analysis ; Female ; Hospital admission and discharge ; Hospitalization ; Hospitals ; Humans ; Infant ; Male ; Patient outcomes ; Patient Readmission - economics ; Patient Readmission - statistics & numerical data ; Pediatrics ; Pneumonia ; Pneumonia - economics ; Pneumonia - therapy ; Regression analysis ; Retrospective Studies</subject><ispartof>Pediatrics (Evanston), 2014-07, Vol.134 (1), p.100-109</ispartof><rights>Copyright © 2014 by the American Academy of Pediatrics.</rights><rights>Copyright American Academy of Pediatrics Jul 2014</rights><rights>Copyright © 2014 by the American Academy of Pediatrics 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c456t-915acddf21f234e990d9ed287f7bc2c15f15c876e355a0c80d3bf86fa8a6787c3</citedby><cites>FETCH-LOGICAL-c456t-915acddf21f234e990d9ed287f7bc2c15f15c876e355a0c80d3bf86fa8a6787c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24958590$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Neuman, Mark I</creatorcontrib><creatorcontrib>Hall, Matthew</creatorcontrib><creatorcontrib>Gay, James C</creatorcontrib><creatorcontrib>Blaschke, Anne J</creatorcontrib><creatorcontrib>Williams, Derek J</creatorcontrib><creatorcontrib>Parikh, Kavita</creatorcontrib><creatorcontrib>Hersh, Adam L</creatorcontrib><creatorcontrib>Brogan, Thomas V</creatorcontrib><creatorcontrib>Gerber, Jeffrey S</creatorcontrib><creatorcontrib>Grijalva, Carlos G</creatorcontrib><creatorcontrib>Shah, Samir S</creatorcontrib><title>Readmissions among children previously hospitalized with pneumonia</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>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.
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.
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.
Readmissions are common after hospitalization for pneumonia, especially among young children and those with chronic medical conditions, and are associated with substantial costs.</description><subject>Admission and discharge</subject><subject>Bacterial pneumonia</subject><subject>Care and treatment</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children & youth</subject><subject>Cohort Studies</subject><subject>Confidence intervals</subject><subject>Costs and Cost Analysis</subject><subject>Female</subject><subject>Hospital admission and discharge</subject><subject>Hospitalization</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Patient outcomes</subject><subject>Patient Readmission - economics</subject><subject>Patient Readmission - statistics & numerical data</subject><subject>Pediatrics</subject><subject>Pneumonia</subject><subject>Pneumonia - economics</subject><subject>Pneumonia - therapy</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkUtv1DAURi1ERYfCliWKxIZNpn7G9gapjHhJlSohWFse-2bGlccOcVIovx6HKVXLygsff77nfgi9InhNBKfnA_iyppjwFjNGnqAVwVq1nErxFK0wZqTlGItT9LyUa4wxF5I-Q6eUa6GExiv0_itYfwilhJxKYw857Rq3D9GPkJphhJuQ5xJvm30uQ5hsDL_BNz_DtG-GBHPFg32BTnobC7y8O8_Q948fvm0-t5dXn75sLi5bx0U3tZoI67zvKekp46A19ho8VbKXW0cdET0RTskOmBAWO4U92_aq662ynVTSsTP07pg7zNsDeAdpGm00wxgOdrw12Qbz-CaFvdnlG8MFI1ThGvD2LmDMP2Yok6niDmK0CaqlWRbacVVnqOib_9DrPI-p6i0UF5RJwSvVHqmdjWBCcjlN8GtyOUbYgan2mytzwaQUWkumK78-8m7MpYzQ3w9P8N_fzVKnWeo0S531weuHyvf4v_7YH4H6nHg</recordid><startdate>20140701</startdate><enddate>20140701</enddate><creator>Neuman, Mark I</creator><creator>Hall, Matthew</creator><creator>Gay, James C</creator><creator>Blaschke, Anne J</creator><creator>Williams, Derek J</creator><creator>Parikh, Kavita</creator><creator>Hersh, Adam L</creator><creator>Brogan, Thomas V</creator><creator>Gerber, Jeffrey S</creator><creator>Grijalva, Carlos G</creator><creator>Shah, Samir S</creator><general>American Academy of Pediatrics</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20140701</creationdate><title>Readmissions among children previously hospitalized with pneumonia</title><author>Neuman, Mark I ; Hall, Matthew ; Gay, James C ; Blaschke, Anne J ; Williams, Derek J ; Parikh, Kavita ; Hersh, Adam L ; Brogan, Thomas V ; Gerber, Jeffrey S ; Grijalva, Carlos G ; Shah, Samir S</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c456t-915acddf21f234e990d9ed287f7bc2c15f15c876e355a0c80d3bf86fa8a6787c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Admission and discharge</topic><topic>Bacterial pneumonia</topic><topic>Care and treatment</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children & youth</topic><topic>Cohort Studies</topic><topic>Confidence intervals</topic><topic>Costs and Cost Analysis</topic><topic>Female</topic><topic>Hospital admission and discharge</topic><topic>Hospitalization</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Patient outcomes</topic><topic>Patient Readmission - economics</topic><topic>Patient Readmission - statistics & numerical data</topic><topic>Pediatrics</topic><topic>Pneumonia</topic><topic>Pneumonia - economics</topic><topic>Pneumonia - therapy</topic><topic>Regression analysis</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Neuman, Mark I</creatorcontrib><creatorcontrib>Hall, Matthew</creatorcontrib><creatorcontrib>Gay, James C</creatorcontrib><creatorcontrib>Blaschke, Anne J</creatorcontrib><creatorcontrib>Williams, Derek J</creatorcontrib><creatorcontrib>Parikh, Kavita</creatorcontrib><creatorcontrib>Hersh, Adam L</creatorcontrib><creatorcontrib>Brogan, Thomas V</creatorcontrib><creatorcontrib>Gerber, Jeffrey S</creatorcontrib><creatorcontrib>Grijalva, Carlos G</creatorcontrib><creatorcontrib>Shah, Samir S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Neuman, Mark I</au><au>Hall, Matthew</au><au>Gay, James C</au><au>Blaschke, Anne J</au><au>Williams, Derek J</au><au>Parikh, Kavita</au><au>Hersh, Adam L</au><au>Brogan, Thomas V</au><au>Gerber, Jeffrey S</au><au>Grijalva, Carlos G</au><au>Shah, Samir S</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Readmissions among children previously hospitalized with pneumonia</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2014-07-01</date><risdate>2014</risdate><volume>134</volume><issue>1</issue><spage>100</spage><epage>109</epage><pages>100-109</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><coden>PEDIAU</coden><abstract>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.
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.
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.
Readmissions are common after hospitalization for pneumonia, especially among young children and those with chronic medical conditions, and are associated with substantial costs.</abstract><cop>United States</cop><pub>American Academy of Pediatrics</pub><pmid>24958590</pmid><doi>10.1542/peds.2014-0331</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Admission and discharge Bacterial pneumonia Care and treatment Child Child, Preschool Children & youth Cohort Studies Confidence intervals Costs and Cost Analysis Female Hospital admission and discharge Hospitalization Hospitals Humans Infant Male Patient outcomes Patient Readmission - economics Patient Readmission - statistics & numerical data Pediatrics Pneumonia Pneumonia - economics Pneumonia - therapy Regression analysis Retrospective Studies |
| title | Readmissions among children previously hospitalized with pneumonia |
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