Measuring Pediatric Hospital Readmission Rates to Drive Quality Improvement

Additional References

Importance of readmissions

Social and clinical burdens

Davidson JE, Jones C, Bienvenu OJ. Family response to critical illness: postintensive care syndrome-family. Crit Care Med. 2012;40(2):618-624. doi:10.1097/CCM.0b013e318236ebf9.

Rennick JE, Johnston CC, Dougherty G, Platt R, Ritchie JA. Children’s psychological responses after critical illness and exposure to invasive technology. J Dev Behav Pediatr. 2002;23(3):133-144.

Shudy M, de Almeida ML, Ly S, et al. Impact of pediatric critical illness and injury on families: a systematic literature review. Pediatrics. 2006;118 Suppl 3:S203-218. doi:10.1542/peds.2006-0951B.

Prevalence

Leyenaar JK, Lagu T, Shieh M-S, Pekow PS, Lindenauer PK. Management and outcomes of pneumonia among children with complex chronic conditions. Pediatr Infect Dis J. 2014. doi:10.1097/INF.0000000000000317.

Springel T, Laskin B, Furth S. Readmission within 30 days of hospital discharge among children receiving chronic dialysis. Clin J Am Soc Nephrol. 2014;9(3):536-542. doi:10.2215/CJN.05410513.

Disparities

Beck AF, Huang B, Simmons JM, et al. Role of financial and social hardships in asthma racial disparities. Pediatrics. 2014;133(3):431-439. doi:10.1542/peds.2013-2437.

Brousseau DC, Owens PL, Mosso AL, Panepinto JA, Steiner CA. Acute care utilization and rehospitalizations for sickle cell disease. JAMA. 2010;303(13):1288-1294. doi:10.1001/jama.2010.378.

Liu SY, Pearlman DN. Hospital readmissions for childhood asthma: the role of individual and neighborhood factors. Public Health Rep. 2009;124(1):65-78. 2

Newman NC, Ryan PH, Huang B, Beck AF, Sauers HS, Kahn RS. Traffic-related air pollution and asthma hospital readmission in children: a longitudinal cohort study. J Pediatr. 2014;164(6):1396-1402.e1. doi:10.1016/j.jpeds.2014.02.017.

Rodriguez F, Joynt KE, López L, Saldaña F, Jha AK. Readmission rates for Hispanic Medicare beneficiaries with heart failure and acute myocardial infarction. Am Heart J. 2011;162(2):254-261.e3. doi:10.1016/j.ahj.2011.05.009.

Readmissions and quality

Preventability

Vest JR, Gamm LD, Oxford BA, Gonzalez MI, Slawson KM. Determinants of preventable readmissions in the United States: a systematic review. Implement Sci. 2010;5:88. doi:10.1186/1748-5908-5-88.

Association with quality

Bozic KJ, Maselli J, Pekow PS, Lindenauer PK, Vail TP, Auerbach AD. The influence of procedure volumes and standardization of care on quality and efficiency in total joint replacement surgery. J Bone Joint Surg Am. 2010;92(16):2643-2652. doi:10.2106/JBJS.I.01477.

Bridges JFP, Dor A, Grossman M. A wolf dressed in sheep’s clothing: perhaps quality measures are just unmeasured severity. Appl Health Econ Health Policy. 2005;4(1):55- 64.

Chen JY, Ma Q, Chen H, Yermilov I. New bundled world: quality of care and readmission in diabetes patients. J Diabetes Sci Technol. 2012;6(3):563-571.

Gorodeski EZ, Starling RC, Blackstone EH. Are all readmissions bad readmissions? N Engl J Med. 2010;363(3):297-298. doi:10.1056/NEJMc1001882.

Huesch MD, Ong MK, Fonarow GC. Measuring heart failure care by 30-day readmission: Rethinking the quality of outcome measures. Am Heart J. 2013;166(4):605-610.e2. doi:10.1016/j.ahj.2013.07.026.

Kun SS, Edwards JD, Ward SLD, Keens TG. Hospital readmissions for newly discharged pediatric home mechanical ventilation patients. Pediatr Pulmonol. 2012;47(4):409-414. doi:10.1002/ppul.21536.

Ludke RL, MacDowell NM, Booth BM, Hunter SA. Appropriateness of admissions and discharges among readmitted patients. Health Serv Res. 1990;25(3):501-525. 3

Morse RB, Hall M, Fieldston ES, et al. Hospital-level compliance with asthma care quality measures at children’s hospitals and subsequent asthma-related outcomes. JAMA. 2011;306(13):1454-1460. doi:10.1001/jama.2011.1385.

Schmeida M, Savrin RA. Pneumonia rehospitalization of the Medicare fee-for-service patient: a state-level analysis: exploring 30-day readmission factors. Prof Case Manag. 2012;17(3):126-131. doi:10.1097/NCM.0b013e31823be14d.

Stefan MS, Pekow PS, Nsa W, et al. Hospital performance measures and 30-day readmission rates. J Gen Intern Med. 2013;28(3):377-385. doi:10.1007/s11606-012- 2229-8.

Hospital versus health system accountability

Kocher RP, Adashi EY. Hospital readmissions and the affordable care act: Paying for coordinated quality care. JAMA. 2011;306(16):1794-1795. doi:10.1001/jama.2011.1561.

Press MJ, Scanlon DP, Ryan AM, et al. Limits of readmission rates in measuring hospital quality suggest the need for added metrics. Health Aff (Millwood). 2013;32(6):1083-1091. doi:10.1377/hlthaff.2012.0518.

Potential for improvement

Interventions

Anderson C, Deepak BV, Amoateng-Adjepong Y, Zarich S. Benefits of comprehensive inpatient education and discharge planning combined with outpatient support in elderly patients with congestive heart failure. Congest Heart Fail. 2005;11(6):315-321.

Balaban RB, Weissman JS, Samuel PA, Woolhandler S. Redefining and redesigning hospital discharge to enhance patient care: a randomized controlled study. J Gen Intern Med. 2008;23(8):1228-1233. doi:10.1007/s11606-008-0618-9.

Brown JR, Chang C-H, Zhou W, MacKenzie TA, Malenka DJ, Goodman DC. Health system characteristics and rates of readmission after acute myocardial infarction in the United States. J Am Heart Assoc. 2014;3(3). doi:10.1161/JAHA.113.000714.

Costantino ME, Frey B, Hall B, Painter P. The influence of a postdischarge intervention on reducing hospital readmissions in a Medicare population. Popul Health Manag. 2013;16(5):310-316. doi:10.1089/pop.2012.0084.

Evans RL, Hendricks RD. Evaluating hospital discharge planning: a randomized clinical trial. Med Care. 1993;31(4):358-370. 4

Flood KL, Maclennan PA, McGrew D, Green D, Dodd C, Brown CJ. Effects of an acute care for elders unit on costs and 30-day readmissions. JAMA Intern Med. 2013:1-7. doi:10.1001/jamainternmed.2013.524.

Harrison PL, Hara PA, Pope JE, Young MC, Rula EY. The impact of postdischarge telephonic follow-up on hospital readmissions. Popul Health Manag. 2011;14(1):27-32. doi:10.1089/pop.2009.0076.

Jack BW, Chetty VK, Anthony D, et al. A reengineered hospital discharge program to decrease rehospitalization: a randomized trial. Ann Intern Med. 2009;150(3):178-187.

Koehler BE, Richter KM, Youngblood L, et al. Reduction of 30-day postdischarge hospital readmission or emergency department (ED) visit rates in high-risk elderly medical patients through delivery of a targeted care bundle. J Hosp Med. 2009;4(4):211-218. doi:10.1002/jhm.427.

Leschke J, Panepinto JA, Nimmer M, Hoffmann RG, Yan K, Brousseau DC. Outpatient follow-up and rehospitalizations for sickle cell disease patients. Pediatr Blood Cancer. 2012;58(3):406-409. doi:10.1002/pbc.23140.

Naylor MD, Brooten DA, Campbell RL, Maislin G, McCauley KM, Schwartz JS. Transitional care of older adults hospitalized with heart failure: a randomized, controlled trial. J Am Geriatr Soc. 2004;52(5):675-684. doi:10.1111/j.1532-5415.2004.52202.x.

Naylor M, Brooten D, Jones R, Lavizzo-Mourey R, Mezey M, Pauly M. Comprehensive discharge planning for the hospitalized elderly. A randomized clinical trial. Ann Intern Med. 1994;120(12):999-1006.

Phillips CO, Wright SM, Kern DE, Singa RM, Shepperd S, Rubin HR. Comprehensive discharge planning with postdischarge support for older patients with congestive heart failure: a meta-analysis. JAMA. 2004;291(11):1358-1367. doi:10.1001/jama.291.11.1358.

Rich MW, Beckham V, Wittenberg C, Leven CL, Freedland KE, Carney RM. A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. N Engl J Med. 1995;333(18):1190-1195. doi:10.1056/NEJM199511023331806.

Scott IA. Preventing the rebound: improving care transition in hospital discharge processes. Aust Health Rev. 2010;34(4):445-451. doi:10.1071/AH09777.

Sochalski J, Jaarsma T, Krumholz HM, et al. What works in chronic care management: the case of heart failure. Health Aff. 2009;28(1):179-189. doi:10.1377/hlthaff.28.1.179. 5

Factors other than quality that influence readmissions

Clinical progression and planned care

Young WW, Joyce DZ, Emes J, Lucking J, Schwarzbach. Readmissions: Are They an Indicator of Quality of Care? Pittsburgh Business Group on Health and Blue Cross of Western Pennsylvania; 1991. Available at: http://www.ichsr.com/publications/pdf/Readmissions.pdf.

Socioeconomic factors

Liem RI, O’Suoji C, Kingsberry PS, et al. Access to patient-centered medical homes in children with sickle cell disease. Matern Child Health J. 2014. doi:10.1007/s10995-013- 1429-0.

Quon EC, McGrath JJ. Subjective socioeconomic status and adolescent health: A meta- analysis. Health Psychol. 2013. doi:10.1037/a0033716.

Shaw LJ, Merz CNB, Bittner V, et al. Importance of socioeconomic status as a predictor of cardiovascular outcome and costs of care in women with suspected myocardial ischemia. Results from the National Institutes of Health, National Heart, Lung and Blood Institute-sponsored Women’s Ischemia Syndrome Evaluation (WISE). J Womens Health (Larchmt). 2008;17(7):1081-1092. doi:10.1089/jwh.2007.0596.

Effects of readmission policies

Activation toward improvement

Hansen LO, Greenwald JL, Budnitz T, et al. Project BOOST: Effectiveness of a multihospital effort to reduce rehospitalization. J Hosp Med. 2013;8(8):421-427. doi:10.1002/jhm.2054.

Massachusetts Executive Office of Health and Human Services. MassHealth Quality Exchange (MassQEX). Available at: http://massqex.ehs.state.ma.us/massqex/index/hqi. Accessed October 1, 2013.

Ohio Hospital Association. Preventable Readmissions Fact Sheet. 2011. Available at: http://www.ohanet.org/wp-content/uploads/2012/02/ReadmissionsFactSheet2.pdf. Accessed January 16, 2014.