Abstract
ObjectivesAnalysis of frequency and reasons for planned and unplanned 30-day readmission in hospitalized pediatric otorhinolaryngology patients using German Diagnosis Related Group (G-DRG) system data.MethodsA retrospective population-based cohort study in Thuringia, Germany, was performed for the year 2015 with 2440 cases under 18 years (55.6% male) out of a total number of 15.271 inpatient cases. The majority of pediatric patients were from 2 to 5 years old (54.5%). The most frequent diagnoses were hyperplasia of adenoids or/and tonsils (26.6%). 36 cases (1.5%) experienced readmission within 30-days.Results30-day readmission was planned in 9 cases (25% of all readmission) and was unplanned in 27 cases (75%). The median interval between index and readmission treatment was 8 days. Postoperative bleeding after adenoidectomy, tonsillotomy/tonsillectomy or tracheostomy (33.4%) and infectious complications after surgery like acute otitis media, abscess formation or fever (36.2%) were the most frequent reasons for 30-day readmission. Compared to adults treated in 2015 in Thuringia, the readmission rate was higher in adult patients (8.9%) than in this pediatric cohort. In contrast to children, readmissions in adults were mainly planned (65.1%) with a different spectrum of underlying diseases and reasons for readmission.ConclusionThe 30-day readmission rate seemed to be lower for pediatric otolaryngology patients compared to adult patients. Unplanned readmissions dominated in pediatric patients, whereas planned readmissions dominated in adults.
Highlights
Hospital readmissions are an outcome measure used in heath service research as a metric for health care quality [1]
We investigated in the present study the differences in frequency and reasons for readmission between children under 18 years and adults in 2015 in Thuringia
Material and methods A retrospective analysis was performed in seven of eight Thuringian hospitals that have a department of otorhinolaryngology
Summary
Hospital readmissions are an outcome measure used in heath service research as a metric for health care quality [1]. Some studies have published 30 day readmission rates of specific pediatric surgeries such as pediatric bone and soft tissue sarcoma surgery [5], urachal remnants [6], congenital heart surgery [7], esophageal atresia [8] and burn injured patients [9], but not in an overall pediatric otorhinolaryngological cohort. We have published a population-based study for analyzing the 30-day unplanned readmission rate in otorhinolaryngology patients [10]. The 30-day readmission was planned in 4.9% and unplanned in 2.8%. A multivariate analysis revealed that discharge due to patient’s request against medical advice was a strong independent factor with high risk for unplanned readmission. Surgery at index admission was the second important independent risk factor for unplanned readmission
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