title: Maturational, comorbid, maternal and discharge domain impact on preterm rehospitalizations: a comparison of planned and unplanned rehospitalizations.
abstract: OBJECTIVE
  To determine the predictive value of (1) maternal, (2) maturational, (3) comorbid and (4) discharge domains associated with preterm infant rehospitalization.
  
  
  METHODS
  Retrospective, cohort study of preterm infants discharged home from a level IV neonatal intensive care unit. Rates of unplanned and planned 6-month readmissions were assessed. The four domains were modeled incrementally and separately to predict relative and combined contributions to the readmission risk.
  
  
  RESULTS
  Out of 504 infants, 5% had 30-day readmissions (22 unplanned, three planned). By 6 months, 13% were rehospitalized (52 unplanned, 15 planned). Sixty-seven infants had 96 readmission events with 30% of readmission events elective. The four domains together predicted 78% of total 1-month, all 6-month and unplanned 6-month readmissions. Discharge complexity was as predictive as comorbidity in all models.
  
  
  CONCLUSIONS
  These four-domain models were more predictive than single domains. Many total readmission events were planned, suggesting parsing planned and unplanned rehospitalizations may benefit quality-improvement efforts.
authors.affiliation: Department of Pediatrics, Division of Newborn Medicine, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: S
authors.initials: S
authors.lastname: Schell
authors.affiliation: Department of Pediatrics, Division of Newborn Medicine, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: J S
authors.initials: JS
authors.lastname: Kase
authors.affiliation: Department of Pediatrics, Division of Newborn Medicine, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: B
authors.initials: B
authors.lastname: Parvez
authors.affiliation: Department of Pediatrics, Division of Newborn Medicine, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: S I
authors.initials: SI
authors.lastname: Shah
authors.affiliation: School of Aging Studies, College of Behavioral and Community Sciences, University of South Florida, Tampa, FL, USA.
authors.forename: H
authors.initials: H
authors.lastname: Meng
authors.affiliation: Department of Public Health, Brody School of Medicine, Greenville, NC, USA.
authors.forename: M
authors.initials: M
authors.lastname: Grzybowski
authors.affiliation: Department of Pediatrics, Division of Newborn Medicine, Maria Fareri Children's Hospital at Westchester Medical Center, New York Medical College, Valhalla, NY, USA.
authors.forename: H L
authors.initials: HL
authors.lastname: Brumberg
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008297:Male; D009035:Mothers; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D058996:Quality Improvement; D012189:Retrospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors