title: Parent and Physician Perceptions Regarding Preventability of Pediatric Readmissions.
abstract: OBJECTIVE
  To assess the causes and preventability of pediatric readmissions from the perspectives of parents and their physicians to guide future interventions.
  
  
  METHODS
  Parent interview, physician survey, and medical record review were completed for children who were readmitted to a pediatric hospitalist service within 30 days of an index admission. Questions were asked about Health Belief Model constructs (perceived severity, susceptibility or preventability of admission, and perceived barriers), discharge readiness, and follow-up plans. Parent and physician perceptions about reasons for readmissions were examined, and responses to open-ended questions were coded.
  
  
  RESULTS
  60 parent-physician pairs completed the study. The mean age of the patients was 6.43 (SD 6.42) years; 45% (n=27) had a chronic disease, and 47% (n=28) of patients were readmitted with the same or similar condition as in the previous hospitalization. At readmission, parents were more likely than physicians to think that the condition was serious (parent 98%, physician 76%; P<.001) and that the readmission could have been prevented (parent 59%, physician 36%; P=.04). Most parents (63%) and physicians (65%) thought it was likely that the child may have future hospitalizations. Opportunities to prevent readmission included need for parent education, improving medication access and adherence, and need for coordination of follow-up care.
  
  
  CONCLUSIONS
  Many parents and physicians thought the readmission was preventable, and the majority of both thought that the patient was susceptible to another hospitalization. Parents and physicians suggest opportunities to improve care processes during hospitalization and in services provided after discharge to reduce readmissions.
authors.affiliation: Department of Pediatric Medicine, All Children's Hospital, Johns Hopkins Medicine, St Petersburg, Florida; dipti.amin@allkids.org.
authors.forename: Dipti
authors.initials: D
authors.lastname: Amin
authors.affiliation: Department of Pediatrics, Joe DiMaggio Hospital, Fort Lauderdale, Florida; and.
authors.forename: Ronald
authors.initials: R
authors.lastname: Ford
authors.affiliation: Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Sharon R
authors.initials: SR
authors.lastname: Ghazarian
authors.affiliation: Department of Pediatric Medicine, All Children's Hospital, Johns Hopkins Medicine, St Petersburg, Florida;
authors.forename: Benjamin
authors.initials: B
authors.lastname: Love
authors.affiliation: Department of Pediatrics, Johns Hopkins University, Baltimore, Maryland.
authors.forename: Tina L
authors.initials: TL
authors.lastname: Cheng
mesh_terms: D001294:Attitude to Health; D002648:Child; D002908:Chronic Disease / Q000523:psychology / Q000628:therapy; D004505:Education, Nonprofessional / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D020380:Needs Assessment; D010290:Parents / Q000523:psychology*; D010351:Patient Discharge / Q000592:standards*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000379:methods / Q000592:standards; D010820:Physicians / Q000523:psychology*; D011314:Preventive Health Services / Q000379:methods / Q000592:standards; D058996:Quality Improvement; D012938:Social Perception