Ann & Robert H. Lurie Children's Hospital of Chicago issued the following announcement on Feb. 13.
Major changes in child-focused policy (eg, insurance coverage) and practice (care coordination) over the last two decades have led to substantive changes in pediatric clinical care. In this nationally representative study of pediatric hospitalizations across all health conditions, the authors evaluated trends in discharges (hospital stays) and readmissions for 2010-2016 (n=2,714,235 index discharges). The total number of hospital discharges decreased by 21.3% during the study period. Meanwhile, the proportion of discharges with 1 or more complex chronic conditions increased from 16.7% to 22.4% (p <.001) and the readmission rate increased from 6.3% to 7.0% (p <.001), suggesting increasing acuity of illness over time.
Key Points to Remember
Click for Larger ImageThe principal sources of data were the National Readmissions Database and the Nationwide Inpatient Sample, both maintained by the US Agency for Healthcare Research and Quality. The authors conducted multiple subanalyses to understand the time trends in more detail. When the authors examined risks of readmission and adjusted for patient-level characteristics such as complexity of illness, they found that readmission rates declined or remained stable across all patient groups. At the hospital level, hospital discharges for children were increasingly concentrated in metropolitan teaching hospitals (from 30% in 2010 to 57% in 2016). Over time, readmission rates were stable in large hospitals (≥1000 admissions) and decreased in metropolitan teaching hospitals. Overall, likely multiple factors are contributing to these trends, one of which is that increasing survival of children with previously fatal conditions may be driving hospital discharges over time. In addition, the progressive regionalization of pediatric hospital care in metropolitan teaching hospitals has concerning implications for access to hospital-level care for children who live in more rural areas. Of note, this study excluded hospital discharges for children <1 year of age.
http://pediatrics.aappublications.org/content/143/2/e20181958
Original source can be found here.
Source: Ann & Robert H. Lurie Children's Hospital of Chicago
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