Pediatric readmission rates by hospital type for 17 diagnoses

Mackenzie Bean - Print  | 

Readmission rates among pediatric patients with the same diagnosis vary greatly based on hospital type, according to a study published in the Journal of Hospital Medicine. 

A team of researchers led by Amanda Montalbano, MD, a physician in the division of urgent care and department of pediatrics at Kansas City, Mo.-based Children's Mercy Hospital conducted the study. Researchers calculated average readmission rates and corresponding Achievable Benchmarks of Care for the 17 most common readmission diagnoses in patients under age 18. ABCs are used to establish realistic quality performance benchmarks for hospitals.

Researchers looked at 690,949 discharges at 525 metropolitan teaching hospitals, 552 metropolitan nonteaching hospitals and 587 nonmetropolitan hospitals. The discharges occurred between Jan. 1 and Nov. 30, 2014, and were recorded in the Healthcare Utilization Project 2014 Nationwide Readmissions Database.

Researchers found significant variation in readmission rates between hospitals. However, sickle cell disease had the highest readmission rate across all hospital types. They concluded that it is important to take hospital types into account when establishing quality benchmarks, such as ABCs.

Here is a breakdown of average readmission rate based on hospital type:

Appendectomy

Metropolitan teaching hospitals: 4.8 percent

Metropolitan nonteaching hospitals: 4.4 percent

Nonmetropolitan hospitals: 4.1 percent

Tonsil and adenoid procedures

Metropolitan teaching hospitals: 4 percent

Metropolitan nonteaching hospitals: 1.9 percent

Nonmetropolitan hospitals: 2.6 percent

Viral illness

Metropolitan teaching hospitals: 4.7 percent

Metropolitan nonteaching hospitals: 2.2 percent

Nonmetropolitan hospitals: 3 percent

Infections of upper respiratory tract

Metropolitan teaching hospitals: 4.7 percent

Metropolitan nonteaching hospitals: 2.7 percent

Nonmetropolitan hospitals: 1.5 percent

Bronchiolitis

Metropolitan teaching hospitals: 4.4 percent

Metropolitan nonteaching hospitals: 1.5 percent

Nonmetropolitan hospitals: 1.6 percent

Pneumonia

Metropolitan teaching hospitals: 4.2 percent

Metropolitan nonteaching hospitals: 2.4 percent

Nonmetropolitan hospitals: 1.6 percent

Nonbacterial gastroenteritis

Metropolitan teaching hospitals: 5.5 percent

Metropolitan nonteaching hospitals: 2.9 percent

Nonmetropolitan hospitals: 2.2 percent

Hypovolemia and related electrolyte disorders

Metropolitan teaching hospitals: 7.7 percent

Metropolitan nonteaching hospitals: 3.9 percent

Nonmetropolitan hospitals: 1.6 percent

Kidney and urinary tract infections

Metropolitan teaching hospitals: 4.7 percent

Metropolitan nonteaching hospitals 3.7 percent

Nonmetropolitan hospitals: 1 percent

Asthma

Metropolitan teaching hospitals: 2.6 percent

Metropolitan nonteaching hospitals: 1.8 percent

Nonmetropolitan hospitals: 1.1 percent

Diabetes

Metropolitan teaching hospitals: 5 percent

Metropolitan nonteaching hospitals: 4.3 percent

Nonmetropolitan hospitals: 6.3 percent

Seizure

Metropolitan teaching hospitals: 6.3 percent

Metropolitan nonteaching hospitals: 4.2 percent

Nonmetropolitan hospitals: 3.4 percent

Sickle cell anemia crisis

Metropolitan teaching hospitals: 15.7 percent

Metropolitan nonteaching hospitals: 14.7 percent

Nonmetropolitan hospitals: 12.8 percent

Bipolar disorders

Metropolitan teaching hospitals: 8.9 percent

Metropolitan nonteaching hospitals: 11.7 percent

Nonmetropolitan hospitals: 4.8 percent

Childhood behavioral disorders

Metropolitan teaching hospitals: 7.6 percent

Metropolitan nonteaching hospitals: 4.3 percent

Nonmetropolitan hospitals: 2.9 percent

Depression except major depressive disorder

Metropolitan teaching hospitals: 5.6 percent

Metropolitan nonteaching hospitals: 3.2 percent

Nonmetropolitan hospitals: 1.9 percent

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