Preventing Readmissions in Children: How Do We Do That?

[摘要] It is frankly unbelievable that we know so little about preventing hospital readmissions in children despite (1) 60 years of readmission study and discussion across the world1; (2) national endorsement of measurement and reduction of readmissions by esteemed entities such as the National Quality Forum, the Centers for Medicare and Medicare Services, and the Agency for Healthcare Research and Quality2–4; (3) computer software designed to measure preventable readmissions5; and (4) financial penalties to hospitals (including children’s hospitals) with too many readmissions.6–8 There has been tremendous fervor about readmissions in adult patients, but this fervor does not sizzle at the same amplitude in children. To begin with, children (in general) have lower readmission rates than adults.9–12 Furthermore, in children, there is neither a wealth of data correlating quality of discharge care with readmission nor a clear understanding of best practices to prevent readmissions.13–15So what’s the big deal with readmissions in children? Should we even care about them? Of course we should. First, many children do have a problem with discharge care (eg, incorrect dosing of a medication) that negatively affects their health after discharge. The burden placed on a family (and the accompanying stress) to remedy problems and issues regarding a child’s health after discharge can be devastating. The experience of worsening health after discharge and returning for another hospitalization is always an unwelcome occurrence in the life of a child. Readmissions, like all hospitalizations, are expensive, and they expose children to the dangers of the hospital environment (eg, nosocomial pathogens, adverse events). Finally, some children, especially those with medical complexity, have readmission rates that are as high as or higher than those for adult patients.10Central to the issue of readmissions …

[学科分类] 儿科学

[关键词] Campylobacter;proljev;dob