Format

Send to

Choose Destination
See comment in PubMed Commons below
J Pediatr Surg. 2013 Jun;48(6):1389-94. doi: 10.1016/j.jpedsurg.2013.03.039.

Relationship between unplanned readmission and total treatment-related hospital days following management of complicated appendicitis at 31 children's hospitals.

Author information

1
Department of Pediatric Surgery, Children's Hospital Boston, Harvard Medical School, Boston, MA 02115, USA.

Abstract

PURPOSE:

To examine the correlation between readmission rate and total hospital days as resource utilization and quality measures for comparative analysis.

METHODS:

Retrospective three-year audit of 8948 patients admitted with complicated appendicitis at 31 children's hospitals (6/2008-6/2011). Rates of unplanned readmission and cumulative LOS from all index and readmission encounters were analyzed for each hospital through 90 days of follow-up. The relative number and distribution of outlier hospitals identified by each measure were then compared.

RESULTS:

Significant variation was found between hospitals for readmission (aggregate rate: 13.8%, range:5.6-27.1%, chi(2) p<0.0001) and for cumulative LOS (aggregate median: 5 days, range: 4 days [IQR: 3-6] to 7 days [IQR: 4-11],Wilcoxon p<0.0001). Ten (32%) hospitals were identified as outliers by readmission rate and 11 (35%) by cumulative LOS. Although a similar number of outliers were identified for both measures, there was poor agreement in assigning high and low-utilization outlier status to individual hospitals (Weighted Kappa=0.102 [95% CI: -0.167 to 0.386]). Only 2/6 (33%) low-utilizers by readmission rate were low-utilizers by cumulative LOS, and only 2/4 (50%) low-utilizers by cumulative LOS were low-utilizers by readmission rate.

CONCLUSIONS:

There is poor correlation between unplanned readmission and total hospital days following treatment for complicated appendicitis in children. Research and reporting for this condition should incorporate both measures to provide a more comprehensive assessment of resource utilization.

KEYWORDS:

Appendicitis; Cost-effectiveness; Quality improvement; Readmission; Resource Utilization; Surgery

PMID:
23845635
DOI:
10.1016/j.jpedsurg.2013.03.039
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Support Center