Predictors of 30-day readmission and association with primary care follow-up plans.

摘要: Objective To test the hypothesis that missing primary care follow-up plans in discharge summary is associated with higher 30-day readmissions. Study design This retrospective cohort study included pediatric patients discharged from Mattel Children's Hospital, University of California, Los Angeles between July 2008 and 2010. Exclusions deaths, transfers, neonatal discharges, stays under 24 hours, over 18 years age. Bivariate propensity weighted multivariate logistic regressions tested relationships readmission patient demographics, illness severity, documentation provider (PCP) at discharge. Results There were 7794 index discharges (representing 5056 unique patients), 1457 readmissions within 30 days (18.7%). Average length stay was 6.3 days. Being 15-18 old, (OR 1.42 [1.02-1.96]), having public insurance 1.48 [1.20-1.83]), or All-Patient Refined Diagnosis-Related Group severity scores (for severity=4 vs 1, OR 6.88 [4.99-9.49]) increased odds readmission. After adjusting for status, Asian 1.46 [1.01-2.12]) but not Black Hispanic, race/ethnicity greater Fifteen percent 172 medical records a randomly selected month 2010 documented PCP plans. documenting significantly 4.52 [1.01-20.31]). Conclusion Readmission rates are complex quality measures, may be rather than lower Additional studies needed to understand inpatient-outpatient transition.