National estimates of 30-day readmissions among children hospitalized for asthma in the United States.

National estimates of 30-day readmissions among children hospitalized for asthma in the United States.

J Asthma. 2017 Aug 24;:0

Authors: Veeranki SP, Ohabughiro MU, Moran J, Mehta HB, Ameredes BT, Kuo YF, Calhoun WJ

Abstract
Objective Previous single-center studies have reported that up to 40% of children hospitalized for asthma will be readmitted. The study objectives are to investigate the prevalence and timing of 30-day readmissions in children hospitalized with asthma, and to identify factors associated with 30-day readmissions. Methods Data (n = 12,842) for children aged 6-18 years hospitalized for asthma were obtained from the 2013 Nationwide Readmission Database (NRD). The primary study outcome was time to readmission within 30 days after discharge attributable to any cause. Several predictors associated with risk of admission were included: patient (age, sex, median household income, insurance type, county location, pediatric chronic complex condition), admission (type, day, emergency services utilization, length of stay (LOS), discharge disposition) and hospital (ownership, bed size, teaching status). Cox's Proportional Hazards model was used to identify predictors. Results Of 12,842 asthma-related index hospitalizations, 2.5% were readmitted within 30 days post discharge. Time to event models identified significantly higher risk of readmission among asthmatic children aged 12-18 years, those who resided in in micropolitan counties, those with >4 days LOS during index hospitalization, those who were hospitalized in urban hospital, who had unfavorable discharge (HR 2.53, 95% CI 1.33-4.79), and those who were diagnosed with PCCC, respectively than children in respective referent categories. Conclusion A multi-dimensional approach including effective asthma discharge action plans and follow-up processes, home-based asthma education, and neighborhood/community-level efforts to address disparities should be integrated into routine clinical care of asthma children.

PMID: 28837382 [PubMed - as supplied by publisher]

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