Exploring 30-day children?s readmission rate in a general hospital.
K van Driel1*, GS de Wolf2, R. van Schaik3
1 Division woman and child, Diakonessenhuis Utrecht, the Netherlands
2Department of clinical methods and Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
3Division woman and child, Diakonessenhuis Utrecht, the Netherlands
* Corresponding author: K van Driel, Division Woman and Child Diakonessenhuis Utrecht, the Netherlands, Neonatology ward 5 B Box 80250, NL-3508 TG Utrecht, the Netherlands. Email: kvdriel2@diakhuis.nl
Abstract
Background
Thirty-day urgent and elective all cause readmission rates were indicated as one of the quality indicators …show more content…
In the USA and United Kingdom hospitals are being penalized for higher than expected readmission rates (2,3,4). From 2015 onwards the Dutch Inspectorate of Public Health included hospital readmission rates as one of the indicators to assess patient safety (1). The validity of hospital readmissions as an indicator of quality of care depends on the extent that readmissions are avoidable(5). A readmission is potentially preventable if it is considered to be clinically related to the previous (initial) admission and if there is a reasonable expectation that it could have been prevented. Previous research of readmissions is primarily conducted in children?s hospitals(6-8). There is only little information about readmission rates of pediatric wards of general hospitals in the Netherlands and other countries. It is unclear how readmissions rates and characteristics in children?s hospitals relate to those in general hospitals. Therefore, the aim of the current study is to quantify and describe the incidence and proportion of urgent and elective readmissions in and their association with age, conditions, readmission interval, length of stay and to identify potentially avoidable readmissions. Comment by karin: Weggelaten"prevented by one or more of the following: wordt nl al genoemd in de …show more content…
To provide insight in the kind of readmissions and their patterns, we classified all urgent readmissions according to a system developed in England (9,10) (appendix 3). ICD-10 codes used in this system were not available, therefore the corresponding DBC ?s to the different categories were added by the pediatricians of the Diakonessenhuis(appendix3). Readmissions are categorized(cat) as possible complications, readmissions with same DBC as initial admission(cat A), readmissions of children with chronic illnesses(cat B), readmissions after self discharge(cat C), coding mistakes(cat D), broadly related; same organ system as initial admission(cat E), unrelated; different organ system as initial admission(cat F) and readmissions related to social economic problems(cat G). The first category (possible complications) is considered to be potentially preventable, but preventable readmissions can be present in other categories as well. We added two extra subcategories namely, readmission is originated in different organ system but still related to the initial admission(cat E2) and readmission is originated in same organ system but is not related to initial admission(cat F2). Per category we calculated the number and percentage of total urgent readmissions. Comment by karin: Deze zin naar boven verplaatst, zo loopt het beter denk
K van Driel1*, GS de Wolf2, R. van Schaik3
1 Division woman and child, Diakonessenhuis Utrecht, the Netherlands
2Department of clinical methods and Public Health, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
3Division woman and child, Diakonessenhuis Utrecht, the Netherlands
* Corresponding author: K van Driel, Division Woman and Child Diakonessenhuis Utrecht, the Netherlands, Neonatology ward 5 B Box 80250, NL-3508 TG Utrecht, the Netherlands. Email: kvdriel2@diakhuis.nl
Abstract
Background
Thirty-day urgent and elective all cause readmission rates were indicated as one of the quality indicators …show more content…
In the USA and United Kingdom hospitals are being penalized for higher than expected readmission rates (2,3,4). From 2015 onwards the Dutch Inspectorate of Public Health included hospital readmission rates as one of the indicators to assess patient safety (1). The validity of hospital readmissions as an indicator of quality of care depends on the extent that readmissions are avoidable(5). A readmission is potentially preventable if it is considered to be clinically related to the previous (initial) admission and if there is a reasonable expectation that it could have been prevented. Previous research of readmissions is primarily conducted in children?s hospitals(6-8). There is only little information about readmission rates of pediatric wards of general hospitals in the Netherlands and other countries. It is unclear how readmissions rates and characteristics in children?s hospitals relate to those in general hospitals. Therefore, the aim of the current study is to quantify and describe the incidence and proportion of urgent and elective readmissions in and their association with age, conditions, readmission interval, length of stay and to identify potentially avoidable readmissions. Comment by karin: Weggelaten"prevented by one or more of the following: wordt nl al genoemd in de …show more content…
To provide insight in the kind of readmissions and their patterns, we classified all urgent readmissions according to a system developed in England (9,10) (appendix 3). ICD-10 codes used in this system were not available, therefore the corresponding DBC ?s to the different categories were added by the pediatricians of the Diakonessenhuis(appendix3). Readmissions are categorized(cat) as possible complications, readmissions with same DBC as initial admission(cat A), readmissions of children with chronic illnesses(cat B), readmissions after self discharge(cat C), coding mistakes(cat D), broadly related; same organ system as initial admission(cat E), unrelated; different organ system as initial admission(cat F) and readmissions related to social economic problems(cat G). The first category (possible complications) is considered to be potentially preventable, but preventable readmissions can be present in other categories as well. We added two extra subcategories namely, readmission is originated in different organ system but still related to the initial admission(cat E2) and readmission is originated in same organ system but is not related to initial admission(cat F2). Per category we calculated the number and percentage of total urgent readmissions. Comment by karin: Deze zin naar boven verplaatst, zo loopt het beter denk