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Pediatric Trauma and Burn Patient Unplanned 30 Day Readmissions
Krista K. Wheeler, MS1,2, Junxin Shi, MD, PhD1,2, Huiyun Xiang, MD, MPH, PhD1,2,3, Rajan K. Thakkar, MD1,3,4, Jonathan I. Groner, MD1,3,4. 1Center for Pediatric Trauma Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA, 2Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA, 3The Ohio State University College of Medicine, Columbus, OH, USA, 4Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, USA.

Objective: Public insurers and accountable care organizations are increasingly looking at readmissions to evaluate care. We identified pediatric trauma patients with higher rates of readmission in the National Readmission Database (NRD), a new Healthcare Cost and Utilization Project dataset.

Methods: The 2013 NRD has discharge records from 21 States. Patients were tracked across hospitals within a state using patient linkage numbers and combined records for transferred patients. We have produced preliminary 30 day unplanned (non-elective) readmission rates across patient, injury, and hospital factors. We adjusted for patient case mix with logistic regression when comparing hospital level factors.

Results: In 2013, among an estimated 72,653 pediatric trauma patients, 1.9% (95% CI: 1.6 - 2.2) of pediatric trauma and burn patients had unplanned readmissions within 30 days. Pediatric burn patients had the highest readmission rates (3.4%, 95% CI: 1.6 – 5.2). In separate logistic models for trauma and burn patients, we did not see differences in children’s hospitals versus non-children’s hospitals or across patient volumes of trauma and burn patients. Pediatric trauma patients with chronic conditions and injury severity scores > 15 had significantly increased adjusted odds ratios (AOR) of readmission. Older burn patients (age >12 years) and burn patients requiring an OR procedure (AOR=2.5, 95% CI: 1.04 - 5.86) were more likely to be readmitted.

Conclusions: The NRD can be used to identify injured children with higher readmission rates, so that hospitals can target care coordination resources for these patients.

Objective: Identify injured pediatric patient populations with higher readmission rates

Content: At the end of this activity, the learner will be able to target pediatric trauma patient populations with increased care coordination needs.

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