Mark S Brittan1, Marion R Sills2, David Fox2, Elizabeth J Campagna3, Doron Shmueli3, James A Feinstein2, Allison Kempe2. 1. Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO; Children's Outcome Research Program, University of Colorado School of Medicine, Aurora, CO. Electronic address: mark.brittan@childrenscolorado.org. 2. Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO; Children's Outcome Research Program, University of Colorado School of Medicine, Aurora, CO. 3. Children's Outcome Research Program, University of Colorado School of Medicine, Aurora, CO.
Abstract
OBJECTIVE: To examine the association between postdischarge outpatient follow-up and 30-day readmissions in Medicaid enrolled children with complex, chronic conditions. STUDY DESIGN: This was a retrospective cohort analysis of Colorado Medicaid recipients with complex, chronic conditions who were discharged from the hospital between 2006 and 2008. The primary outcome was readmission between 4 and 30 days after index hospital discharge. Using multivariable logistic regression, we examined the association between early postdischarge outpatient visits (≤ 3 days postdischarge) and readmission. We secondarily analyzed the relationship between any outpatient visit from 4 to 29 days of index discharge and readmission. RESULTS: For the 2415 patients with complex, chronic conditions included in the analysis, the 4- to 30-day readmission rate was 6.3%. The odds of readmission was significantly greater for patients with ≥ 1 outpatient visit ≤ 3 days after discharge compared with patients without a visit ≤ 3 days after discharge (aOR 1.7 [1.1-2.4]). The odds of readmission were significantly lower for patients with ≥ 1 outpatient visit from 4 to 29 days after discharge compared with patients without such visits (aOR 0.5 [0.3-0.7]). Other factors associated with readmission included index hospital length of stay and number of complex, chronic conditions. CONCLUSIONS: In medically complex children, there is a positive association between early postdischarge outpatient follow-up and readmission. There is an inverse association between later postdischarge outpatient follow-up and readmission. Outpatient follow-up occurring within 4-29 days after discharge may help to prevent 30-day readmissions. Additional research is needed to inform guidelines regarding longer term postdischarge outpatient follow-up in these children.
OBJECTIVE: To examine the association between postdischarge outpatient follow-up and 30-day readmissions in Medicaid enrolled children with complex, chronic conditions. STUDY DESIGN: This was a retrospective cohort analysis of Colorado Medicaid recipients with complex, chronic conditions who were discharged from the hospital between 2006 and 2008. The primary outcome was readmission between 4 and 30 days after index hospital discharge. Using multivariable logistic regression, we examined the association between early postdischarge outpatient visits (≤ 3 days postdischarge) and readmission. We secondarily analyzed the relationship between any outpatient visit from 4 to 29 days of index discharge and readmission. RESULTS: For the 2415 patients with complex, chronic conditions included in the analysis, the 4- to 30-day readmission rate was 6.3%. The odds of readmission was significantly greater for patients with ≥ 1 outpatient visit ≤ 3 days after discharge compared with patients without a visit ≤ 3 days after discharge (aOR 1.7 [1.1-2.4]). The odds of readmission were significantly lower for patients with ≥ 1 outpatient visit from 4 to 29 days after discharge compared with patients without such visits (aOR 0.5 [0.3-0.7]). Other factors associated with readmission included index hospital length of stay and number of complex, chronic conditions. CONCLUSIONS: In medically complex children, there is a positive association between early postdischarge outpatient follow-up and readmission. There is an inverse association between later postdischarge outpatient follow-up and readmission. Outpatient follow-up occurring within 4-29 days after discharge may help to prevent 30-day readmissions. Additional research is needed to inform guidelines regarding longer term postdischarge outpatient follow-up in these children.
Authors: Yanbo Xu; Mohammad Taha Bahadori; Elizabeth Searles; Michael Thompson; Tejedor-Sojo Javier; Jimeng Sun Journal: AMIA Annu Symp Proc Date: 2018-04-16
Authors: Chén C Kenyon; Siobhan M Gruschow; Wren L Haaland; Arti D Desai; Sarah A Adams; Talia A Hitt; Derek J Williams; David P Johnson; Rita Mangione-Smith Journal: Acad Pediatr Date: 2018-07-25 Impact factor: 3.107
Authors: Michelle Y Hamline; Rebecca L Speier; Paul Dai Vu; Daniel Tancredi; Alia R Broman; Lisa N Rasmussen; Brian P Tullius; Ulfat Shaikh; Su-Ting T Li Journal: Pediatrics Date: 2018-10-23 Impact factor: 7.124