Factors Associated with Readmission of Pediatric Patients in a Developing Nation
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To determine the incidence of readmission in pediatric patients in a tertiary care hospital in a developing nation and to ascertain factors precipitating readmissions.
A prospective study was conducted from February 2016 through January 2017 at a tertiary care hospital. Children between 1 mo to 15 y of age were included if they were readmitted within 60 d of discharge. The risk factors for readmission were determined on the basis of medical record review and a structured questionnaire and the ascribed cause of readmission was grouped into three categories: Patient specific factors, Hospital specific factors and Unrelated/ New illness.
The readmission rate was 3%, out of which 80.66% were found to be causally related to the index admission. Several sociodemographic characteristics i.e. lack of health information like television, lower socioeconomic status, absence of adequate breastfeeding, lower age, migrants were found to be significantly associated with readmission along with other patient specific factors like presence of cardiac disease, presence of comorbid conditions like anemia, malnutrition, and global developmental delay. The most important cause for readmission was determined as patient specific (48.66%) followed by hospital specific (38%) and unknown/unrelated factors (13.33%).
The progression of the primary illness and social determinants of pediatric readmissions are important contributing risk factors for readmission in developing countries in pediatric patients. Multicentric studies are needed from this region of the world to include different hospital readmissions rate and to address the issue of potential preventability of pediatric readmissions.
KeywordsHospital readmissions Children’s hospital Pediatrics Child health research
The authors thank Dr. Anusha Ramesh, Dr. Neha Bidhuri, Dr. Preeti Kukreja, Dr. Praveen, Dr. Navjot Saini for helping with the data collection. They would also like to thank Kirti Ranjan and Bhawna Garg for helping with data analysis and Ms. Reena Mehta for the technical support.
DK: Conception and design of the study, drafting the article and revising it critically for important intellectual content and final approval of the version to be submitted; SS: Acquisition of data and analysis and interpretation of data, drafting the article or revising it critically for important intellectual content and final approval of the version to be submitted; GS: Conception and design of the study, acquisition of data and drafting the article; SA: Conception and design of the study, drafting the article and final approval of the version to be submitted; AS, PJ, NS: Acquisition of data and analysis and interpretation of data, drafting the article. DK will act as guarantor for this paper.
Compliance with Ethical Standards
Conflict of Interest
Informed written consent was obtained from the parents for reporting the case.