Readmission rates among pediatric patients with the same diagnosis vary greatly based on hospital type, according to a study published in the Journal of Hospital Medicine.
A team of researchers led by Amanda Montalbano, MD, a physician in the division of urgent care and department of pediatrics at Kansas City, Mo.-based Children's Mercy Hospital conducted the study. Researchers calculated average readmission rates and corresponding Achievable Benchmarks of Care for the 17 most common readmission diagnoses in patients under age 18. ABCs are used to establish realistic quality performance benchmarks for hospitals.
Researchers looked at 690,949 discharges at 525 metropolitan teaching hospitals, 552 metropolitan nonteaching hospitals and 587 nonmetropolitan hospitals. The discharges occurred between Jan. 1 and Nov. 30, 2014, and were recorded in the Healthcare Utilization Project 2014 Nationwide Readmissions Database.
Researchers found significant variation in readmission rates between hospitals. However, sickle cell disease had the highest readmission rate across all hospital types. They concluded that it is important to take hospital types into account when establishing quality benchmarks, such as ABCs.
Here is a breakdown of average readmission rate based on hospital type:
Appendectomy
Metropolitan teaching hospitals: 4.8 percent
Metropolitan nonteaching hospitals: 4.4 percent
Nonmetropolitan hospitals: 4.1 percent
Tonsil and adenoid procedures
Metropolitan teaching hospitals: 4 percent
Metropolitan nonteaching hospitals: 1.9 percent
Nonmetropolitan hospitals: 2.6 percent
Viral illness
Metropolitan teaching hospitals: 4.7 percent
Metropolitan nonteaching hospitals: 2.2 percent
Nonmetropolitan hospitals: 3 percent
Infections of upper respiratory tract
Metropolitan teaching hospitals: 4.7 percent
Metropolitan nonteaching hospitals: 2.7 percent
Nonmetropolitan hospitals: 1.5 percent
Bronchiolitis
Metropolitan teaching hospitals: 4.4 percent
Metropolitan nonteaching hospitals: 1.5 percent
Nonmetropolitan hospitals: 1.6 percent
Pneumonia
Metropolitan teaching hospitals: 4.2 percent
Metropolitan nonteaching hospitals: 2.4 percent
Nonmetropolitan hospitals: 1.6 percent
Nonbacterial gastroenteritis
Metropolitan teaching hospitals: 5.5 percent
Metropolitan nonteaching hospitals: 2.9 percent
Nonmetropolitan hospitals: 2.2 percent
Hypovolemia and related electrolyte disorders
Metropolitan teaching hospitals: 7.7 percent
Metropolitan nonteaching hospitals: 3.9 percent
Nonmetropolitan hospitals: 1.6 percent
Kidney and urinary tract infections
Metropolitan teaching hospitals: 4.7 percent
Metropolitan nonteaching hospitals 3.7 percent
Nonmetropolitan hospitals: 1 percent
Asthma
Metropolitan teaching hospitals: 2.6 percent
Metropolitan nonteaching hospitals: 1.8 percent
Nonmetropolitan hospitals: 1.1 percent
Diabetes
Metropolitan teaching hospitals: 5 percent
Metropolitan nonteaching hospitals: 4.3 percent
Nonmetropolitan hospitals: 6.3 percent
Seizure
Metropolitan teaching hospitals: 6.3 percent
Metropolitan nonteaching hospitals: 4.2 percent
Nonmetropolitan hospitals: 3.4 percent
Sickle cell anemia crisis
Metropolitan teaching hospitals: 15.7 percent
Metropolitan nonteaching hospitals: 14.7 percent
Nonmetropolitan hospitals: 12.8 percent
Bipolar disorders
Metropolitan teaching hospitals: 8.9 percent
Metropolitan nonteaching hospitals: 11.7 percent
Nonmetropolitan hospitals: 4.8 percent
Childhood behavioral disorders
Metropolitan teaching hospitals: 7.6 percent
Metropolitan nonteaching hospitals: 4.3 percent
Nonmetropolitan hospitals: 2.9 percent
Depression except major depressive disorder
Metropolitan teaching hospitals: 5.6 percent
Metropolitan nonteaching hospitals: 3.2 percent
Nonmetropolitan hospitals: 1.9 percent