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Research: Readmission Rates Don’t Measure Pediatric Care Quality

August 26, 2013
by Gabriel Perna
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According to research from UC San Francisco (UCSF), hospital 30-day readmissions rates for children do not accurately measure the quality of their care.

Readmission rates for of adult patients have become a specific area of focus for hospital leaders, as they prepare to deal with Centers for Medicare & Medicaid Services’ (CMS) possible penalties. Excessive readmission rates are seen as anindicator of clinical failure and unnecessary expenditures.

The UCSF study, however, says that in pediatric care being admitted into the hospital again or visiting the emergency room within 30 days of discharge doesn’t indicate a lack of quality. The researchers found that when comparing hospitals’ performance based on revisits, there weren’t that many children’s hospitals that could be identified as being better or worse than average based on revisits, even for common pediatric diagnoses.

“As a national way of assessing and tracking hospital quality, pediatric readmissions and revisits, at least for specific diagnoses, are not useful to families trying to find a good hospital, nor to the hospitals trying to improve their pediatric care,” stated Naomi Bardach, M.D., an assistant professor of pediatrics at UCSF Benioff Children’s Hospital and lead author. “Measuring and reporting them publicly would waste limited hospital and health care resources.”

The researchers used State Inpatient and Emergency Department Databases to look at 958 hospitals admitting children, which were mostly large or medium-sized, and urban. They look at seven common inpatient pediatric conditions – asthma, dehydration, pneumonia, appendicitis, skin infections, mood disorders and epilepsy – and calculated the rates of readmissions and revisits to the hospital within 30 and 60 days of discharge, broken down by the condition for which they were treated.

All of the hospitals in the study had 30-day readmission rates of less than 5 percent in all areas except for epilepsy (6.1 percent), dehydration (6 percent) and mood disorders (7.6 percent).

It’s not the first time readmission rate has been called into question as a legitimate way to test a hospital’s quality of care. Earlier this year, the Harvard School of Public Health released a study indicating the potential danger of the Centers for Medicare and Medicaid Services’ (CMS) Federal Readmissions Reduction Program. Other studies from Ottawa Hospital Research Institute (OHRI) and Loyola University Medical Center looked at the potential flaws of assessing hospitals through readmission rates.

The findings will be published in the September issue of journal Pediatrics.



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