Trends in Pediatric Hospitalizations and Readmissions: 2010-2016
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. Data from the 2010-2016 Healthcare Cost and Utilization Projec...
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| Veröffentlicht in: | Pediatrics (Evanston) 2019-02, Vol.143 (2), p.1 |
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| creator | Bucholz, Emily M Toomey, Sara L Schuster, Mark A |
| description | 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.
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.
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.
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. |
| doi_str_mv | 10.1542/peds.2018-1958 |
| format | Article |
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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.
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.
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.</description><identifier>ISSN: 0031-4005</identifier><identifier>ISSN: 1098-4275</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.2018-1958</identifier><identifier>PMID: 30696756</identifier><language>eng</language><publisher>United States: American Academy of Pediatrics</publisher><subject>Admission and discharge ; Adolescent ; Analysis ; Child ; Child, Preschool ; Children ; Chronic Disease - therapy ; Chronic Disease - trends ; Chronic illnesses ; Female ; Hospital admission and discharge ; Hospitalization - trends ; Hospitals ; Hospitals, Pediatric - trends ; Humans ; Infant ; Male ; Medical practice ; Medicine ; Patient Acceptance of Health Care ; Patient Readmission - trends ; Pediatric research ; Pediatrics ; Poisson density functions ; Practice ; Trends</subject><ispartof>Pediatrics (Evanston), 2019-02, Vol.143 (2), p.1</ispartof><rights>Copyright © 2019 by the American Academy of Pediatrics.</rights><rights>Copyright American Academy of Pediatrics Feb 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c456t-a39fb0be1195481b3bc23a6842e92144ea4946e61a08c898600ffd34e8d8c8ad3</citedby><cites>FETCH-LOGICAL-c456t-a39fb0be1195481b3bc23a6842e92144ea4946e61a08c898600ffd34e8d8c8ad3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30696756$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bucholz, Emily M</creatorcontrib><creatorcontrib>Toomey, Sara L</creatorcontrib><creatorcontrib>Schuster, Mark A</creatorcontrib><title>Trends in Pediatric Hospitalizations and Readmissions: 2010-2016</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>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.
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.
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.
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.</description><subject>Admission and discharge</subject><subject>Adolescent</subject><subject>Analysis</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Children</subject><subject>Chronic Disease - therapy</subject><subject>Chronic Disease - trends</subject><subject>Chronic illnesses</subject><subject>Female</subject><subject>Hospital admission and discharge</subject><subject>Hospitalization - trends</subject><subject>Hospitals</subject><subject>Hospitals, Pediatric - trends</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Medical practice</subject><subject>Medicine</subject><subject>Patient Acceptance of Health Care</subject><subject>Patient Readmission - trends</subject><subject>Pediatric research</subject><subject>Pediatrics</subject><subject>Poisson density functions</subject><subject>Practice</subject><subject>Trends</subject><issn>0031-4005</issn><issn>1098-4275</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkcFrFDEUxoModq1ePcqAFy-zvkxeMokHaVmqFQoVqeeQmbxZU2aTdTIr6l_fDFuLeklI8sv3vo-PsZcc1lxi83ZPPq8b4LrmRupHbMXB6BqbVj5mKwDBawSQJ-xZzrcAgLJtnrITAcqoVqoVO7uZKPpchVh9Jh_cPIW-ukx5H2Y3ht9uDinmykVffSHndyHn5eJdVUZCXRb1nD0Z3Jjpxf1-yr5-uLjZXNZX1x8_bc6v6h6lmmsnzNBBR7zYRM070fWNcEpjQ6bhiOTQoCLFHeheG60AhsELJO3L2Xlxyt4fdfeHbke-pzhPbrT7Kezc9MsmF-y_LzF8s9v0w6pWITayCLy5F5jS9wPl2ZY0PY2ji5QO2Ta8LQ5QgCjo6__Q23SYYolXKI1gDKIpVH2ktm4kG2Kf4kw_5z6NI23JlvSba3suNWg0AAu_PvL9lHKeaHgwz8EuZdqlTLuUaZcyy4dXf0d-wP-0J-4AA32YVw</recordid><startdate>201902</startdate><enddate>201902</enddate><creator>Bucholz, Emily M</creator><creator>Toomey, Sara L</creator><creator>Schuster, Mark A</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>201902</creationdate><title>Trends in Pediatric Hospitalizations and Readmissions: 2010-2016</title><author>Bucholz, Emily M ; Toomey, Sara L ; Schuster, Mark A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c456t-a39fb0be1195481b3bc23a6842e92144ea4946e61a08c898600ffd34e8d8c8ad3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Admission and discharge</topic><topic>Adolescent</topic><topic>Analysis</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Children</topic><topic>Chronic Disease - therapy</topic><topic>Chronic Disease - trends</topic><topic>Chronic illnesses</topic><topic>Female</topic><topic>Hospital admission and discharge</topic><topic>Hospitalization - trends</topic><topic>Hospitals</topic><topic>Hospitals, Pediatric - trends</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Medical practice</topic><topic>Medicine</topic><topic>Patient Acceptance of Health Care</topic><topic>Patient Readmission - trends</topic><topic>Pediatric research</topic><topic>Pediatrics</topic><topic>Poisson density functions</topic><topic>Practice</topic><topic>Trends</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bucholz, Emily M</creatorcontrib><creatorcontrib>Toomey, Sara L</creatorcontrib><creatorcontrib>Schuster, Mark A</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>Bucholz, Emily M</au><au>Toomey, Sara L</au><au>Schuster, Mark A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Trends in Pediatric Hospitalizations and Readmissions: 2010-2016</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2019-02</date><risdate>2019</risdate><volume>143</volume><issue>2</issue><spage>1</spage><pages>1-</pages><issn>0031-4005</issn><issn>1098-4275</issn><eissn>1098-4275</eissn><abstract>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.
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.
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.
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.</abstract><cop>United States</cop><pub>American Academy of Pediatrics</pub><pmid>30696756</pmid><doi>10.1542/peds.2018-1958</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Admission and discharge Adolescent Analysis Child Child, Preschool Children Chronic Disease - therapy Chronic Disease - trends Chronic illnesses Female Hospital admission and discharge Hospitalization - trends Hospitals Hospitals, Pediatric - trends Humans Infant Male Medical practice Medicine Patient Acceptance of Health Care Patient Readmission - trends Pediatric research Pediatrics Poisson density functions Practice Trends |
| title | Trends in Pediatric Hospitalizations and Readmissions: 2010-2016 |
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