Emergency room visits and readmissions after pediatric urologic surgery.
OBJECTIVE
Reducing readmissions has become a focal point to increase quality of care while reducing costs. We report all-cause unplanned return visits following urologic surgery in children at our institution.


METHODS
Children undergoing urology procedures with returns within 30 days of surgery were identified. Patient demographics, insurance status, type of surgery, and reason for return were assessed.


RESULTS
Four thousand and ninety-seven pediatric urology surgeries were performed at our institution during 2012, with 106 documented unplanned returns (2.59%). Mean time from discharge to return was 5.9 ± 4.9 days (range, 0.3-24.8 days). Returns were classified by chief complaint, including pain (32), infection (30), volume status (14), bleeding (11), catheter concern (8), and other (11). Circumcision, hypospadias repair, and inguinal/scrotal procedures led to the majority of return visits, accounting for 21.7%, 20.7%, and 18.9% of returns, respectively. Twenty-two returns (20.75%) resulted in hospital readmission and five (4.72%) required a secondary procedure. Overall readmission rate was 0.54%, with a reoperation rate of 0.12%.


CONCLUSIONS
The rate of unplanned postoperative returns in the pediatric population undergoing urologic surgery is low, further strengthening the argument that readmission rates in children are not necessarily a productive focal point for financial savings or quality control.
Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA. Electronic address: angarlen@gmail.com.
Angela M
AM
Arlen
Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Laura S
LS
Merriman
Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Kurt F
KF
Heiss
Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Wolfgang H
WH
Cerwinka
Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
James M
JM
Elmore
Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Charlotte A
CA
Massad
Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Edwin A
EA
Smith
Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Bruce H
BH
Broecker
Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA.
Hal C
HC
Scherz
Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA. Electronic address: akirschmd@gmail.com.
Andrew J
AJ
Kirsch
D000367:Age Factors; D000768:Anesthesia, General; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors; D013520:Urologic Surgical Procedures / Q000009:adverse effects*
Emergency department visits; Pediatric readmission; Postoperative returns