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J Pediatr Surg. 2014 Jan;49(1):207-12; discussion 212. doi: 10.1016/j.jpedsurg.2013.09.058. Epub 2013 Oct 5.

Enhancing NSQIP-Pediatric through integration with the Pediatric Health Information System.

Author information

  • 1Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA; Department of Surgery, Nationwide Children's Hospital, Columbus, OH, USA. Electronic address: katherine.deans@nationwidechildrens.org.
  • 2Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA.
  • 3Department of Surgery, Children's Hospital Boston, Boston, MA, USA.
  • 4Department of Surgery, Nationwide Children's Hospital, Columbus, OH, USA.
  • 5Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA; Department of Surgery, Nationwide Children's Hospital, Columbus, OH, USA.

Abstract

PURPOSE:

We implemented and validated a linkage algorithm for cases in both the National Surgical Quality Improvement Program-Pediatric (NSQIP-Peds) and the Pediatric Health Information System (PHIS) to investigate healthcare utilization during the first post-operative year.

METHODS:

NSQIP-Peds and PHIS cases from our institution who were operated on between January 2010 and September 2011 were matched on gender and dates of birth, admission, and discharge. Rates of true matches were validated using medical records. We examined rates of emergency department (ED) visits, hospital readmissions, potentially preventable readmissions (PPR), and hospital charges within one year of the NSQIP-Peds encounter.

RESULTS:

Of the 2,409 NSQIP-Peds and 61,147 PHIS records, 93.6% met match criteria with 92.5% being true matches. Post-operative ED visit rates were 7.8% within 30days, 17.2% between 31-180days, and 18.1% between 181-365days. Readmission rates were 5.5% within 30days, 9.3% between 31-180days, and 8.4% between 181-365days. In patients undergoing inpatient procedures, 10.6% had readmissions within 30days, and 23.7% had readmissions within 365days that were potentially preventable.

CONCLUSIONS:

Using indirect identifiers, a linked NSQIP-Peds-PHIS dataset demonstrated high rates of ED visits, readmissions, and PPR in the first post-operative year. This dataset may provide a more comprehensive way to study health care utilization and clinical outcomes.

© 2014.

KEYWORDS:

Healthcare utilization; NSQIP-Peds; National Surgical Quality Improvement Project-Pediatrics; PHIS; Pediatric Health Information System; Preventable Readmissions

PMID:
24439611
[PubMed - in process]
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