Readmission Rates Not Effective Quality Measure of Pediatric Patient Care


A new study in Pediatrics finds limited use for hospital readmission rates as a meaningful quality measure when it comes to pediatric patient care.

By examining 30- and 60-day readmission rates for 958 hospitals that admit children for seven common inpatient conditions, researchers found very few that could be considered either high or low performers. In addition, pediatric 30-day readmission rates overall were low, at less than 10% for all conditions.

Naomi Bardach, MD, MAS, department of pediatrics at the University of California at San Francisco and the report's lead author, emphasizes that her study was a statistical analysis of readmission rates without assessing whether they should be a focus for quality improvement. "They might be useful for larger efforts, such as multi-institution collaboratives to improve care for a given condition," Dr. Bardach says. "But it is clear that readmission rates are not useful for comparing individual hospital performance."

An accompanying editorial noted that delaying hospital discharges even by four hours in an attempt to forestall readmissions could prove more costly in the end.

Although much of the national focus on 30-day hospital readmissions has been on the Medicare-age population, the pediatric realm is getting more attention, Dr. Bardach says. For example, the Children's Health Insurance Program Reauthorization Act of 2009 funded seven research cooperatives to develop core measures for assessing the state of children’s healthcare quality. TH

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