Readmission Rates for Children May Not Reflect Hospital Performance

Study suggests that parents should base decisions on other factors

By Mary Elizabeth Dallas

Tuesday, August 27, 2013

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TUESDAY, Aug. 27 (HealthDay News) -- Unlike the case with adult readmissions, higher hospital readmission rates for children may not necessarily indicate poor quality of care, according to new research.
Parents or guardians looking for a good pediatric hospital should not base their decision on its readmission rates, the study authors added.
The multistate study tracked rates of children being readmitted to the hospital or visiting the emergency room within one and two months of being discharged for common childhood conditions.
"As a national way of assessing and tracking hospital quality, pediatric readmissions and revisits, at least for specific diagnoses, are not useful to families trying to find a good hospital, nor to the hospitals trying to improve their pediatric care," study author Dr. Naomi Bardach, an assistant professor of pediatrics at the University of California, San Francisco, Benioff Children's Hospital, said in a UCSF news release. "Measuring and reporting them publicly would waste limited hospital and health care resources."
In conducting the study, the researchers examined nearly 1,000 hospitals that admitted children for seven common pediatric conditions: asthma, dehydration, pneumonia, appendicitis, skin infections, mood disorders and epilepsy. They determined the rates of readmissions and visits to the hospital within 30 and 60 days of being discharged for each condition.
The study revealed that 30-day readmission rates were 7.6 percent for mood disorders, 6.1 percent for epilepsy and 6 percent for dehydration. However, 30-day readmission rates for all the other conditions at all the hospitals were less than 5 percent. Given these findings, the researchers concluded that few hospitals that care for kids can be rated as being better or worse based on readmissions.
"With average 30-day readmission rates hovering around 5 percent, there is little space for a hospital to be identified as having better performance," Bardach said.
Only one of the hospitals performed better than average when it came to readmissions for asthma, while four performed worse. Two hospitals performed better than average on appendicitis readmissions and two performed worse. There were no differences among hospitals in average performance for pneumonia and dehydration. Only one hospital of more than 600 performed below average on seizure readmission rates.
"The low number of outliers is likely due to the fact that most hospitals just don't admit very many kids, because children are healthier than adults," Bardach said.
The researchers said larger studies involving children with similar diagnoses could improve the usefulness of readmission rates as a measure of hospital performance or quality of care.
The study will appear in the September issue of the journal Pediatrics.

SOURCE: University of California, San Francisco, news release, Aug. 26, 2013

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