Pediatric cardiac readmissions: An opportunity for quality improvement?. Sacks, J., Kelleman, M, McCracken, C, Glanville, M, & Oster, M Congenit Heart Dis, 12(3):282–288, May, 2017.
Pediatric cardiac readmissions: An opportunity for quality improvement? [link]Paper  doi  abstract   bibtex   
OBJECTIVE: Hospital readmissions are increasingly becoming a metric for quality in the current landscape of changing and cost effective medicine. However, no 30-d readmission rates have been established for pediatric cardiac medical patients in the United States. Thus, the objective was to determine 30 d readmission rates and risk factors associated with readmission for pediatric cardiac patients, hypothesizing that pediatric cardiac patients would have significantly higher readmission rates than their general pediatric counterparts. DESIGN: This was a retrospective cohort study. SETTING: The study took place at a large urban academic children's hospital. PATIENTS: The 1124 included patients were discharged from the medical cardiology service and had an unplanned readmission within 30 d during the period of 2012-2014. MEASURES: Admissions, readmissions, diagnoses, demographics, weights, medications, procedures, length of stay, were all measured. RESULTS: There were 1993 visits and 408 (20.5%) 30-d readmissions in our study. Among the 1124 patients, 219 (19.5%) had at least one 30-d readmission. Patient factors associated with increased likelihood of 30-d readmission were younger age (median: 197.5 vs 1365.5 d, P \textless .0001), lower discharge weight (6.2 v 14.5 kg, P \textless .0001) and greater number of diagnoses (P \textless .0001). The encounter factor associated with a 30-d readmission was longer length of stay (4 vs 2 d, P \textless 0.0001). Factors associated with decreased readmissions were having had an electrophysiology procedure during their stay, taking an angiotensin converting enzyme inhibitor/angiotensin receptor blocker or taking an antibiotic. CONCLUSIONS: Readmissions within 30 d among pediatric cardiology patients are common. The most common factors associated with readmissions are not likely to be modifiable but may serve as important prognostic indicators and as a basis for counseling.
@article{sacks_pediatric_2017,
	title = {Pediatric cardiac readmissions: {An} opportunity for quality improvement?},
	volume = {12},
	url = {https://www.ncbi.nlm.nih.gov/pubmed/27874252},
	doi = {10.1111/chd.12436},
	abstract = {OBJECTIVE: Hospital readmissions are increasingly becoming a metric for quality in the current landscape of changing and cost effective medicine. However, no 30-d readmission rates have been established for pediatric cardiac medical patients in the United States. Thus, the objective was to determine 30 d readmission rates and risk factors associated with readmission for pediatric cardiac patients, hypothesizing that pediatric cardiac patients would have significantly higher readmission rates than their general pediatric counterparts. DESIGN: This was a retrospective cohort study. SETTING: The study took place at a large urban academic children's hospital. PATIENTS: The 1124 included patients were discharged from the medical cardiology service and had an unplanned readmission within 30 d during the period of 2012-2014. MEASURES: Admissions, readmissions, diagnoses, demographics, weights, medications, procedures, length of stay, were all measured. RESULTS: There were 1993 visits and 408 (20.5\%) 30-d readmissions in our study. Among the 1124 patients, 219 (19.5\%) had at least one 30-d readmission. Patient factors associated with increased likelihood of 30-d readmission were younger age (median: 197.5 vs 1365.5 d, P {\textless} .0001), lower discharge weight (6.2 v 14.5 kg, P {\textless} .0001) and greater number of diagnoses (P {\textless} .0001). The encounter factor associated with a 30-d readmission was longer length of stay (4 vs 2 d, P {\textless} 0.0001). Factors associated with decreased readmissions were having had an electrophysiology procedure during their stay, taking an angiotensin converting enzyme inhibitor/angiotensin receptor blocker or taking an antibiotic. CONCLUSIONS: Readmissions within 30 d among pediatric cardiology patients are common. The most common factors associated with readmissions are not likely to be modifiable but may serve as important prognostic indicators and as a basis for counseling.},
	language = {eng},
	number = {3},
	journal = {Congenit Heart Dis},
	author = {Sacks, JH and Kelleman, M and McCracken, C and Glanville, M and Oster, M},
	month = may,
	year = {2017},
	keywords = {United States},
	pages = {282--288}
}

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