Association between hospital type and length of stay and readmissions for young adults with complex chronic diseases.

Autor: Lutmer J; Division of Critical Care Medicine, Center for Clinical Excellence, Nationwide Children's Hospital, Columbus, Ohio, USA., Bucholz E; Department of Pediatrics, Section of Cardiology, University of Colorado Anschutz and Children's Hospital Colorado, Aurora, Colorado, USA., Auger KA; Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA., Hall M; Children's Hospital Association, Lenexa, Kansas, USA., Mitchell Harris J 2nd; Children's Hospital Association, Washington, District of Columbia, USA., Jenkins A; Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA.; Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA., Morse R; Arkansas Children's Northwest, Springdale, Arkansas, USA., Neuman MI; Department of Pediatrics, Division of Emergency Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA., Peltz A; Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA., Simon HK; Departments of Pediatrics and Emergency Medicine, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, Georgia, USA., Teufel RJ 2nd; Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina, USA.
Jazyk: angličtina
Zdroj: Journal of hospital medicine [J Hosp Med] 2024 Oct 15. Date of Electronic Publication: 2024 Oct 15.
DOI: 10.1002/jhm.13524
Abstrakt: Background: There is a paucity of information around whether hospital length of stay and readmission rates differ based upon hospital type for adolescents and young adults (AYA) with complex chronic diseases (CCDs).
Objective: To measure the association between hospital type and readmission rates and index admission LOS among AYA with CCDs.
Methods: We performed a retrospective cross-sectional study of 2017 Healthcare Cost and Utilization Project State Inpatient Databases, including patients 12-25 years old with cystic fibrosis (CF), sickle cell disease (SCD), spina bifida (SB), inflammatory bowel disease (IBD), and diabetes mellitus (DM). Index hospitalizations were categorized by hospital type (pediatric hospitals [PHs], adult hospitals with pediatric services [AHPSs], and adult hospitals without pediatric services [AHs]), CCD, and age group. We compared case-mix adjusted 30-day readmission rates and differences in index admission LOS between hospital types.
Results: Adult hospitals without pediatric services exhibited higher readmission rates (25.4%) than AHPS (22.9%) and PH (15.1%). Compared to patients with CF admitted to AH, lower readmission rates were associated with longer LOS at both AHPS (relative ratio [RR]: 1.25, 95% confidence interval [CI]: 1.02-1.55) and PH (RR: 1.59, 95% CI: 1.28-1.97). Patients with DM admitted to AHPS (odds ratio [OR]: 0.75, 95% CI: 0.62-0.91) and PH (OR: 0.47, 95% CI: 0.31-0.71) also demonstrated lower readmission rates than those admitted to AH.
Conclusions: For AYA with CCD, hospital type is associated with differences in readmission rates and LOS. Lower readmission rates at hospitals with pediatric services compared to adult hospitals without pediatric services suggest hospital type has a significant impact on outcomes.
(© 2024 Society of Hospital Medicine.)
Databáze: MEDLINE
Externí odkaz: