TY  - JOUR
PY  - 2013//
TI  - Measuring hospital quality using pediatric readmission and revisit rates
JO  - Pediatrics
A1  - Bardach, Naomi S.
A1  - Vittinghoff, Eric
A1  - Asteria-Peñaloza, Renée
A1  - Edwards, Jeffrey D.
A1  - Yazdany, Jinoos
A1  - Lee, Henry C.
A1  - Boscardin, W. John
A1  - Cabana, Michael D.
A1  - Dudley, R. Adams
SP  - 429
EP  - 436
VL  - 132
IS  - 3
N2  - OBJECTIVE:To assess variation among hospitals on pediatric readmission and revisit rates and to determine the number of high- and low-performing hospitals.    METHODS:In a retrospective analysis using the State Inpatient and Emergency Department Databases from the Healthcare Cost and Utilization Project with revisit linkages available, we identified pediatric (ages 1-20 years) visits with 1 of 7 common inpatient pediatric conditions (asthma, dehydration, pneumonia, appendicitis, skin infections, mood disorders, and epilepsy). For each condition, we calculated rates of all-cause readmissions and rates of revisits (readmission or presentation to the emergency department) within 30 and 60 days of discharge. We used mixed logistic models to estimate hospital-level risk-standardized 30-day revisit rates and to identify hospitals that had performance statistically different from the group mean.    RESULTS:Thirty-day readmission rates were low (<10.0%) for all conditions. Thirty-day rates of revisit to the inpatient or emergency department setting ranged from 6.2% (appendicitis) to 11.0% (mood disorders). Study hospitals (n = 958) had low condition-specific visit volumes (37.0%-82.8% of hospitals had <25 visits). The only condition with >1% of hospitals labeled as different from the mean on 30-day risk-standardized revisit rates was mood disorders (4.2% of hospitals [n = 15], range of hospital performance 6.3%-15.9%).    CONCLUSIONS:We found that when comparing hospitals' performances to the average, few hospitals that care for children are identified as high- or low-performers for revisits, even for common pediatric diagnoses, likely due to low hospital volumes. This limits the usefulness of condition-specific readmission or revisit measures in pediatric quality measurement.<p />  <p>Language: en</p>
LA  - en
SN  - 0031-4005
UR  - http://dx.doi.org/10.1542/peds.2012-3527
ID  - ref1
ER  -