Unplanned readmissions to acute care from a pediatric postacute care hospital: incidence, clinical reasons, and predictive factors.
OBJECTIVE
To identify the incidence, clinical reasons, and predictive factors for unplanned readmissions to acute care from a pediatric postacute care hospital.


METHODS
A retrospective cohort analysis of all discharges between October 1, 2011, and September 30, 2013 (n=298), in 1 pediatric postacute care hospital was conducted. Descriptive statistics were used to summarize the incidence and assess the clinical reasons for all readmissions to an acute care hospital. Logistic regression was used to identify predictive factors of any unplanned readmission to an acute care hospital.


RESULTS
Thirty percent of all postacute care hospital discharges were unplanned readmissions to an acute care hospital. The primary clinical reasons for unplanned readmissions to acute care were respiratory decompensation (54%) and infection (20%). Requiring invasive mechanical ventilation, being <1 year of age, and having a postacute care length of stay<30 days were the 3 predictive factors.


CONCLUSIONS
This is the first study to examine readmission to acute care from a postacute care hospital and to identify age, length of stay, and dependence on mechanical ventilation as predictive factors. Understanding which children are likely to require an unplanned readmission may allow providers to develop strategies to minimize this occurrence.
Research Center for Children with Special Health Care Needs, Franciscan Hospital for Children, Boston, Massachusetts; and.
Jane E
JE
O'Brien
Research Center for Children with Special Health Care Needs, Franciscan Hospital for Children, Boston, Massachusetts; and hdumas@fhfc.org.
Helene M
HM
Dumas
Research Center for Children with Special Health Care Needs, Franciscan Hospital for Children, Boston, Massachusetts; and.
Carol M
CM
Nash
School of Pharmacy, Massachusetts College of Pharmacy and Health Sciences University, Boston, Massachusetts.
Rania
R
Mekary
D000208:Acute Disease / Q000453:epidemiology / Q000628:therapy; D015984:Causality; D002675:Child, Preschool; D015331:Cohort Studies; D003422:Critical Care / Q000379:methods / Q000706:statistics & numerical data; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D010359:Patient Readmission / Q000706:statistics & numerical data*; D011379:Prognosis; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013997:Time Factors
long-term care; pediatric hospital readmission; rehabilitation; subacute care