One of the key indicators of the quality of a hospital鈥檚 care is how frequently its patients are readmitted within a month after being discharged. A聽study this month examined readmission rates for pediatric patients and found that nearly 30 percent of them may have been preventable.
,聽published online by the journal Pediatrics, reviewed the medical records and conducted interviews with clinicians and parents of 305 children who were readmitted within 30 days to Boston Children鈥檚 Hospital聽between December 2012 and February 2013. It excluded planned readmissions such as those for chemotherapy.
Overall, 6.5 percent of patients were readmitted during the study period.
The study found that 29.5 percent of the pediatric readmissions were potentially preventable. In more than three-quarters of those cases, researchers determined that hospital-related factors played a role. A significantly smaller proportion were related to the patient (39.2 percent), often because of issues that arose after discharge, or the primary care physician (14.5 percent). (Multiple factors played a role in some patients’ readmissions, so the total exceeds 100 percent.)
The most common hospital-related reasons had to do with how patients are assessed,聽postoperative complications or hospital-acquired conditions.
鈥淥ne of the things we need to improve upon is engaging families at the time of discharge around how we鈥檙e feeling and how they鈥檙e feeling about the status of the child at that point in time,鈥 said Dr. Sara Toomey, the study鈥檚 lead author, who is the medical director of patient experience at Boston Children鈥檚 Hospital and an assistant professor at Harvard Medical School.
Sometimes clinicians and family members may be overly optimistic about a child鈥檚 readiness to go home, Toomey said.
When policymakers discuss the importance of reducing hospital readmissions, they typically focus on older patients, who make up a much larger proportion of hospital patients than do pediatric patients. The Medicare program, which provides health benefits for Americans age 65 and older, on hospitals whose readmission rates are too high.
The federal Centers for Medicare & Medicaid Services doesn鈥檛 penalize hospitals for pediatric readmissions, but a growing number of states are doing so, the study found.
Readmissions will never be completely avoidable, Toomey said. Still, 鈥渨hen you have a child coming home from the hospital, there are things you need to know, and the more active people are in creating a plan and making sure they understand it, the better that will help their children.鈥
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