Enhancing NSQIP-Pediatric through integration with the Pediatric Health Information System.
OBJECTIVE
We implemented and validated a linkage algorithm for cases in both the National Surgical Quality Improvement Program-Pediatric (NSQIP-Peds) and the Pediatric Health Information System (PHIS) to investigate healthcare utilization during the first post-operative year.


METHODS
NSQIP-Peds and PHIS cases from our institution who were operated on between January 2010 and September 2011 were matched on gender and dates of birth, admission, and discharge. Rates of true matches were validated using medical records. We examined rates of emergency department (ED) visits, hospital readmissions, potentially preventable readmissions (PPR), and hospital charges within one year of the NSQIP-Peds encounter.


RESULTS
Of the 2,409 NSQIP-Peds and 61,147 PHIS records, 93.6% met match criteria with 92.5% being true matches. Post-operative ED visit rates were 7.8% within 30days, 17.2% between 31-180days, and 18.1% between 181-365days. Readmission rates were 5.5% within 30days, 9.3% between 31-180days, and 8.4% between 181-365days. In patients undergoing inpatient procedures, 10.6% had readmissions within 30days, and 23.7% had readmissions within 365days that were potentially preventable.


CONCLUSIONS
Using indirect identifiers, a linked NSQIP-Peds-PHIS dataset demonstrated high rates of ED visits, readmissions, and PPR in the first post-operative year. This dataset may provide a more comprehensive way to study health care utilization and clinical outcomes.
Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA; Department of Surgery, Nationwide Children's Hospital, Columbus, OH, USA. Electronic address: katherine.deans@nationwidechildrens.org.
Katherine J
KJ
Deans
Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
Jennifer N
JN
Cooper
Department of Surgery, Children's Hospital Boston, Boston, MA, USA.
Shawn J
SJ
Rangel
Department of Surgery, Nationwide Children's Hospital, Columbus, OH, USA.
Mehul V
MV
Raval
Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA; Department of Surgery, Nationwide Children's Hospital, Columbus, OH, USA.
Peter C
PC
Minneci
Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA; Department of Surgery, Nationwide Children's Hospital, Columbus, OH, USA.
R Lawrence
RL
Moss
D019985:Benchmarking; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D063005:Health Information Systems / Q000458:organization & administration*; D006295:Health Resources / Q000706:statistics & numerical data*; D017722:Hospital Charges / Q000706:statistics & numerical data; D006753:Hospital Records; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008498:Medical Record Linkage; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data; D010372:Pediatrics / Q000458:organization & administration* / Q000706:statistics & numerical data; D011184:Postoperative Period; D058996:Quality Improvement / Q000458:organization & administration*; D013043:Specialties, Surgical / Q000458:organization & administration* / Q000706:statistics & numerical data
Healthcare utilization; NSQIP-Peds; National Surgical Quality Improvement Project-Pediatrics; PHIS; Pediatric Health Information System; Preventable Readmissions