Readmission within 30 days of discharge (ReAd): a quality-of-care indicator in paediatric surgery
Following a previously published 1 year audit of readmissions, this is a reaudit of our readmission rate (ReAd) in paediatric surgery, asking: is ReAd reproducible, can it be an indicator of quality of care in paediatric surgery, and can it be improved?
Prospectively collected Hospital Episode statistics were used to identify readmissions over 1 year. Patients were subdivided into emergency vs elective regarding the first admission and outcomes compared including with our previously published ReAd data.
2616 children (67% male) were admitted during 2016: 1398 (53%) elective and 1218 (47%) emergency admissions. The overall ReAd was 0.9%, comparable to and lower than our previously published rate of 2%. The commonest cause for readmission was appendicitis-related (22%). The emergency cohort ReAd was 1.5% (18/1218) compared to 0.4% (5/1398) in the elective cohort, 4× higher (p = 0.002). In the emergency cohort, the commonest causes for readmission were abdominal pain and perforated appendicitis. 80% of elective group readmissions were related to urological procedures. More of these required surgical intervention to treat (80% vs 22%) (p = 0.03).
(1) ReAd is a reproducible and reducible quality-of-care indicator in paediatric surgery. (2) Emergency admission is a risk factor for readmission. (3) Appendicectomy was associated with the highest ReAd.
KeywordsPaediatric surgery 30-Day readmission Readmission Quality-of-care indicator
Compliance with ethical standards
Conflict of interest
No conflicts of interest to declare.
- 1.Intelligent monitoring NHS acute hospitals indicators and methodology (2014) Care quality commission. http://www.cqc.org.uk/files/20141127. Accessed 1 May 2018
- 4.Fischer C, Lingsma HF, Maran-van de Mheen PJ (2014) Is the readmission rate a valid quality indicator? A review of the evidence. PLoS One 9(11):e112282;1–9Google Scholar
- 7.NICE:Costing statement: Transition between inpatient hospital settings and community or care home settings (2015) https://www.nice.org.uk/guidance/ng27/resources/costing-statement-2187244909. Accessed 1 May 2018
- 8.Sinha CK, Decker E, Rex D, Mukhtar Z, Murphy F, Nicholls E, Okoye B, Giuliani S (2016) Thirty days readmission in paediatric surgery: the first UK experience. J Ped Surg 51:1877–1880Google Scholar
- 11.NHS Digital Official Statistics (2015) Compendium—emergency readmissions within 28 days of discharge. https://digital.nhs.uk/data-and-information/publications/clinical-indicators/compendium-of-population-health-indicators/compendium-hospital-care/current/emergency-readmissions-to-hospital-within-28-days-of-discharge. Accessed 1 May 2018
- 12.Thornton GCD, Goldacre MJ, Goldacre R, Howarth LJ (2015) Diagnostic outcomes following childhood non-specific abdominal pain: a record-linkage study. Arch Dis Child 101:299–299Google Scholar
- 13.Barker P, Jutley R, Youngson G (2002) Hospital re-admission in children with non-specific abdominal pain. Pediatr Surg Int 16(5–6) 341–343Google Scholar