Background: Pediatric hospitalization rates for asthma and costs of care have risen in recent years. Hospital readmission can be used to monitor outcomes and quality of care for pediatric asthma. Purpose: This study attempted to identify hospital and patient factors associated with asthma readmissions in children’s hospitals, using Donabedian’s theory on quality assessment. Methods: Using hospital discharge data from 21 children’s hospitals in the United States, this retrospective cohort study included 7,848 children admitted for asthma in 1996. Logistic regression was used to determine whether hospital volume of annual admissions, hospital size, length of stay, previous admission for asthma, use of inhaled steroids during hospitalization, and insurance type were significant predictors of asthma readmission within 30 days, readmission within one year, or multiple readmissions within one year of initial hospitalization. Results: Adjusting for age, sex, race, and APR-DRG severity of illness, previous admission for asthma and admission to a large volume hospital were significant predictors of asthma readmission within 30 days, readmission within one year, and multiple readmissions within one year. Length of stay over one day was a significant predictor of asthma readmission within one year and multiple asthma readmissions. Lack of commercial insurance and use of inhaled steroids during hospitalization were significant predictors of asthma readmission within one year. Conclusions: Identifying risk factors for frequent asthma admissions may reduce preventable hospitalizations and healthcare costs. Quality of care can be improved by monitoring outcomes and targeting interventions to children at risk for asthma readmission.
Learning Objectives: Learning objectives: At the conclusion of this session, the participant will be able to: 1- Recognize specific hospital and patient risk factors associated with pediatric asthma readmission in children’s hospitals 2- Discuss Donabedian’s theory on quality assessment as it applies to outcomes research and hospital readmission for pediatric asthma 3- Evaluate the usefulness of administrative databases and hospital discharge data in developing quality of care indicators to help monitor preventable pediatric hospitalizations
Keywords: Quality of Care, Hospitals
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.