title: Comparison of Clinical Risk Factors Among Pediatric Patients With Single Admission, Multiple Admissions (Without Any 7-Day Readmissions), and 7-Day Readmission.
abstract: OBJECTIVE
  Readmissions have received increasing attention. The goal of this study was to identify demographic and clinical factors associated with hospital utilization and 7-day readmissions.
  
  
  METHODS
  This retrospective case-control study of inpatient and observation encounters was conducted at a freestanding children's hospital. Over a 1-year period, patients were categorized into 3 groups: patients with a single admission, patients with multiple admissions without any 7-day readmissions, and patients with at least one 7-day readmission. Factors associated with risk of future hospital utilization were determined, and post hoc testing was performed to compare groups.
  
  
  RESULTS
  Patients with a single admission had statistically significant lower numbers of medications at admission and discharge, lower rates of home health care at admission and discharge, and fewer diagnosis codes during index admission than patients with multiple admissions. There were no statistically significant differences among patients with multiple admissions between those with and without 7-day readmissions.
  
  
  CONCLUSIONS
  This study found that patients with multiple admissions were similar regardless of whether they had any 7-day readmissions. Because patients with multiple admissions seemed to represent a single high-risk group, it is possible that many readmissions represent a consequence of medical complexity rather than a failure of care. Further studies are necessary to determine if providing targeted interventions to high-risk patients will lower their future hospital utilization.
authors.affiliation: Wolfson Children's Hospital, Jacksonville, Florida jeffrey.winer@jax.ufl.edu.
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Winer
authors.affiliation: Tufts Floating Hospital for Children, Boston, Massachusetts; and.
authors.forename: Elena
authors.initials: E
authors.lastname: Aragona
authors.affiliation: Children's National Health System, Washington, District of Columbia.
authors.forename: Alan I
authors.initials: AI
authors.lastname: Fields
authors.affiliation: Children's National Health System, Washington, District of Columbia.
authors.forename: David C
authors.initials: DC
authors.lastname: Stockwell
mesh_terms: D016022:Case-Control Studies; D002648:Child; D002673:Child, Hospitalized / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D010343:Patient Admission / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors