Pediatric readmissions have negative consequences for families and add health care costs however the pediatric inpatient population has received limited attention. This study sought to measure pediatric unplanned readmissions, calculate readmission rates at acute care hospitals in Massachusetts, and analyze differences by patient and discharge characteristics at the population level.

This analysis adapted the Pediatric All-Condition Readmission Measure developed by the Center of Excellence for Pediatric Quality Measurement to classify admissions resulting in readmission with 30 days of discharge. Pediatric (up to age 18 years plus 30 days) inpatient hospitalizations at acute care hospitals in Massachusetts with an index admission between July 1, 2017 and June 30, 2021 sourced from the Massachusetts Acute Hospital Case Mix Database.

The all-payer pediatric readmission rate in Massachusetts in 2021 was 4.6% and remained stable across study years amidst annual declines in eligible index discharges. Readmission rates were higher for patients aged 1-4 (6.9%) and 5-7 years (6.2%) compared to patients under age 1 (3.4%; p<0.001), and visits with Medicaid (4.7%) as the expected primary payer type compared to visits with commercial payers (4.2%; p<0.05). Readmission rates were higher for medically complex chronic patients (10.4%) compared to non-complex chronic (3.7%) and non-chronic patients (2.3%; p<0.001).

Better understanding patterns of acute care hospital use for pediatric patients is an important step in improving pediatric outcomes, reducing healthcare costs, and addressing disparities. This inaugural statewide study found that one in twenty Massachusetts pediatric patients had a readmission, with higher rates seen in patients insured by Medicaid.