Detection of risk factors for preventable paediatric hospital readmissions
Introduction and objectives: Readmission rate is an indicator of the quality of hospital care. The aim of the study is to identify potential preventable factors for paediatric readmission. Material and methods: A descriptive, analytical, longitudinal, and single centre study was carried out in the P...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | Spanish |
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Elsevier
2019-12-01
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| Series: | Anales de Pediatría (English Edition) |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2341287919301759 |
| _version_ | 1819063075282616320 |
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| author | Jimena Pérez-Moreno Andrea María Leal-Barceló Elena Márquez Isidro Blanca Toledo del castillo Felipe González-Martínez María Isabel González-Sánchez Rosa Rodríguez-Fernández |
| author_facet | Jimena Pérez-Moreno Andrea María Leal-Barceló Elena Márquez Isidro Blanca Toledo del castillo Felipe González-Martínez María Isabel González-Sánchez Rosa Rodríguez-Fernández |
| author_sort | Jimena Pérez-Moreno |
| collection | DOAJ |
| description | Introduction and objectives: Readmission rate is an indicator of the quality of hospital care. The aim of the study is to identify potential preventable factors for paediatric readmission. Material and methods: A descriptive, analytical, longitudinal, and single centre study was carried out in the Paediatric Hospitalisation ward of a tertiary hospital during the period from June 2012 to November 2015. Readmission was defined as the one that occurs in the first 30 days of previous admission, as very early readmission if it occurs in the first 48 h, early readmission in the 2–7 days, and late readmission after 7 days. Preventable readmission is defined as one that takes place in the first 15 days and for the same reason as the first admission. Epidemiological and clinical variables were analysed. A univariate and multivariate study was carried out. Results: In the study period, 5459 patients were admitted to the paediatric hospital, of which 226 of them were readmissions (rate of readmission: 4.1%). When the hospital occupation rate was greater than 70%, the overall percentage of readmissions was significantly higher (8.5% vs 2.5%; P < .001). In the multivariate analysis, it was found that having a chronic disease and the number of visits to emergency care units before admission, are predictive factors of preventable readmission. Conclusions: The rate of readmissions is greater in the periods of higher care pressure. The readmission of patients with chronic condition is preventable, and therefore strategies must be designed to try to avoid them. Resumen: Introducción y objetivos: La tasa de reingresos hospitalarios es un indicador de calidad de la asistencia hospitalaria. El objetivo de este trabajo es describir factores de riesgo de reingreso prevenible en la hospitalización pediátrica. Material y métodos: Estudio analítico, retrospectivo, unicéntrico realizado en las plantas de Pediatría de un hospital terciario (junio de 2012 a noviembre de 2015). Se definió reingreso al que acontecía en los primeros 30 días del ingreso previo: muy precoz (en menos de 48 h), precoz (2-7 días) y tardío (a partir de 7 días). Se definió reingreso prevenible al que ocurrió en los primeros 15 días y por la misma causa del primer ingreso. Se analizaron variables epidemiológicas y clínicas. Se realizó un estudio univariante y posteriormente multivariante. Resultados: En el período de estudio ingresaron en las plantas de Pediatría General Hospitalaria 5.459 pacientes y reingresaron 226 (tasa de reingreso del 4,1%). Cuando la tasa de ocupación hospitalaria es mayor del 70%, el porcentaje global de reingresos es significativamente mayor (8,5 vs. 2,5%), p < 0,001. En el análisis de regresión de Cox se objetivó que la presencia de enfermedad de base y el número de visitas a urgencias desde el alta son factores de predicción de reingreso prevenible. Conclusiones: La tasa de reingresos es mayor en los períodos de mayor presión asistencial. El reingreso de los pacientes con patología crónica de base es prevenible, y por lo tanto hay que diseñar estrategias para intentar evitarlo. |
| first_indexed | 2024-12-21T15:08:54Z |
| format | Article |
| id | doaj.art-61e0316c670b4fe6ad18e11736f0cc64 |
| institution | Directory Open Access Journal |
| issn | 2341-2879 |
| language | Spanish |
| last_indexed | 2024-12-21T15:08:54Z |
| publishDate | 2019-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Anales de Pediatría (English Edition) |
| spelling | doaj.art-61e0316c670b4fe6ad18e11736f0cc642022-12-21T18:59:21ZspaElsevierAnales de Pediatría (English Edition)2341-28792019-12-01916365370Detection of risk factors for preventable paediatric hospital readmissionsJimena Pérez-Moreno0Andrea María Leal-Barceló1Elena Márquez Isidro2Blanca Toledo del castillo3Felipe González-Martínez4María Isabel González-Sánchez5Rosa Rodríguez-Fernández6Hospital General Universitario Gregorio Marañón, Madrid, Spain; Hospital Materno-infantil, Servicio de pediatría, Sección Pediatría Hospitalizados, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, Spain; Corresponding author.Hospital General Universitario Gregorio Marañón, Madrid, Spain; Hospital Materno-infantil, Servicio de pediatría, Sección Pediatría Hospitalizados, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, SpainHospital General Universitario Gregorio Marañón, Madrid, Spain; Hospital Materno-infantil, Servicio de pediatría, Sección Pediatría Hospitalizados, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, SpainHospital General Universitario Gregorio Marañón, Madrid, Spain; Hospital Materno-infantil, Servicio de pediatría, Sección Pediatría Hospitalizados, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, SpainHospital General Universitario Gregorio Marañón, Madrid, Spain; Hospital Materno-infantil, Servicio de pediatría, Sección Pediatría Hospitalizados, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, SpainHospital General Universitario Gregorio Marañón, Madrid, Spain; Hospital Materno-infantil, Servicio de pediatría, Sección Pediatría Hospitalizados, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, SpainHospital General Universitario Gregorio Marañón, Madrid, Spain; Hospital Materno-infantil, Servicio de pediatría, Sección Pediatría Hospitalizados, Instituto de Investigación Sanitaria Gregorio Marañón (IISGM), Madrid, SpainIntroduction and objectives: Readmission rate is an indicator of the quality of hospital care. The aim of the study is to identify potential preventable factors for paediatric readmission. Material and methods: A descriptive, analytical, longitudinal, and single centre study was carried out in the Paediatric Hospitalisation ward of a tertiary hospital during the period from June 2012 to November 2015. Readmission was defined as the one that occurs in the first 30 days of previous admission, as very early readmission if it occurs in the first 48 h, early readmission in the 2–7 days, and late readmission after 7 days. Preventable readmission is defined as one that takes place in the first 15 days and for the same reason as the first admission. Epidemiological and clinical variables were analysed. A univariate and multivariate study was carried out. Results: In the study period, 5459 patients were admitted to the paediatric hospital, of which 226 of them were readmissions (rate of readmission: 4.1%). When the hospital occupation rate was greater than 70%, the overall percentage of readmissions was significantly higher (8.5% vs 2.5%; P < .001). In the multivariate analysis, it was found that having a chronic disease and the number of visits to emergency care units before admission, are predictive factors of preventable readmission. Conclusions: The rate of readmissions is greater in the periods of higher care pressure. The readmission of patients with chronic condition is preventable, and therefore strategies must be designed to try to avoid them. Resumen: Introducción y objetivos: La tasa de reingresos hospitalarios es un indicador de calidad de la asistencia hospitalaria. El objetivo de este trabajo es describir factores de riesgo de reingreso prevenible en la hospitalización pediátrica. Material y métodos: Estudio analítico, retrospectivo, unicéntrico realizado en las plantas de Pediatría de un hospital terciario (junio de 2012 a noviembre de 2015). Se definió reingreso al que acontecía en los primeros 30 días del ingreso previo: muy precoz (en menos de 48 h), precoz (2-7 días) y tardío (a partir de 7 días). Se definió reingreso prevenible al que ocurrió en los primeros 15 días y por la misma causa del primer ingreso. Se analizaron variables epidemiológicas y clínicas. Se realizó un estudio univariante y posteriormente multivariante. Resultados: En el período de estudio ingresaron en las plantas de Pediatría General Hospitalaria 5.459 pacientes y reingresaron 226 (tasa de reingreso del 4,1%). Cuando la tasa de ocupación hospitalaria es mayor del 70%, el porcentaje global de reingresos es significativamente mayor (8,5 vs. 2,5%), p < 0,001. En el análisis de regresión de Cox se objetivó que la presencia de enfermedad de base y el número de visitas a urgencias desde el alta son factores de predicción de reingreso prevenible. Conclusiones: La tasa de reingresos es mayor en los períodos de mayor presión asistencial. El reingreso de los pacientes con patología crónica de base es prevenible, y por lo tanto hay que diseñar estrategias para intentar evitarlo.http://www.sciencedirect.com/science/article/pii/S2341287919301759Reingreso hospitalarioHospital pediátricoCalidad en el cuidado de la salud |
| spellingShingle | Jimena Pérez-Moreno Andrea María Leal-Barceló Elena Márquez Isidro Blanca Toledo del castillo Felipe González-Martínez María Isabel González-Sánchez Rosa Rodríguez-Fernández Detection of risk factors for preventable paediatric hospital readmissions Anales de Pediatría (English Edition) Reingreso hospitalario Hospital pediátrico Calidad en el cuidado de la salud |
| title | Detection of risk factors for preventable paediatric hospital readmissions |
| title_full | Detection of risk factors for preventable paediatric hospital readmissions |
| title_fullStr | Detection of risk factors for preventable paediatric hospital readmissions |
| title_full_unstemmed | Detection of risk factors for preventable paediatric hospital readmissions |
| title_short | Detection of risk factors for preventable paediatric hospital readmissions |
| title_sort | detection of risk factors for preventable paediatric hospital readmissions |
| topic | Reingreso hospitalario Hospital pediátrico Calidad en el cuidado de la salud |
| url | http://www.sciencedirect.com/science/article/pii/S2341287919301759 |
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