ArticleThe Journal of pediatrics2017
Adding Social Determinant Data Changes Children's Hospitals' Readmissions Performance.
Article in The Journal of pediatrics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Applicability of predictive models for 30-day unplanned hospital readmission risk in paediatrics: a systematic review.BMJ open · 2022Pooled it
- Social determinants of health in electronic health records and their impact on analysis and risk prediction: A systematic review.Journal of the American Medical Informatics Association : JAMIA · 2020Pooled it
- Lost Earnings and Nonmedical Expenses of Pediatric Hospitalizations.Pediatrics · 2018Trial
- Social needs and healthcare utilization in NICU graduates.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- A state-level analysis of macro-level factors associated with hospital readmissions.The European journal of health economics : HEPAC : health economics in prevention and care · 2024Article
- Piloting a Clinical Decision Support Tool to Identify Patients With Social Needs and Provide Navigation Services and Referral to Community-Based Organizations: Protocol for a Randomized Controlled Trial.JMIR research protocols · 2024Article
- Implementing Inpatient Social Needs Screening in an Urban Tertiary Care Children's Hospital.Hospital pediatrics · 2024Article
- Realizing the potential of social determinants data in EHR systems: A scoping review of approaches for screening, linkage, extraction, analysis, and interventions.Journal of clinical and translational science · 2024Article
- Identifying the Prevalence and Causes of 30-Day Hospital Readmission in Children: A Case Study from a Tertiary Pediatric Hospital.Global journal on quality and safety in healthcare · 2023Article
- Prevalence of social risk factors and social needs in a Medicaid Accountable Care Organization (ACO).BMC health services research · 2022Article
- Development and Validation of an Integrated Suite of Prediction Models for All-Cause 30-Day Readmissions of Children and Adolescents Aged 0 to 18 Years.JAMA network open · 2022Article
- Adjusting for Social Risk Factors in Pediatric Quality Measures: Adding to the Evidence Base.Academic pediatrics · 2022Article
- Association Between Neighborhood Disadvantage and Pediatric Readmissions.Maternal and child health journal · 2022Article
- Race, Ethnicity, and Insurance: the Association with Opioid Use in a Pediatric Hospital Setting.Journal of racial and ethnic health disparities · 2021Article
- Perspectives of Parents and Providers on Reasons for Mental Health Readmissions: A Content Analysis Study.Administration and policy in mental health · 2021Article
- Leveraging Data and Digital Health Technologies to Assess and Impact Social Determinants of Health (SDoH): a State-of-the-Art Literature Review.Online journal of public health informatics · 2021Article
- HealtheDataLab - a cloud computing solution for data science and advanced analytics in healthcare with application to predicting multi-center pediatric readmissions.BMC medical informatics and decision making · 2020Article
- Association of Medicaid Eligibility With Surgical Readmission Among Medicare Beneficiaries.JAMA network open · 2020Article
- Combining Nonclinical Determinants of Health and Clinical Data for Research and Evaluation: Rapid Review.JMIR public health and surveillance · 2019Review
- Potential Impact of Initial Clinical Data on Adjustment of Pediatric Readmission Rates.Academic pediatrics · 2019Article
Corrections and comments
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Authors and funding
12 authors.
Funding
Abstract
objectivesTo determine whether social determinants of health (SDH) risk adjustment changes hospital-level performance on the 30-day Pediatric All-Condition Readmission (PACR) measure and improves fit and accuracy of discharge-level models. STUDY
designWe performed a retrospective cohort study of all hospital discharges meeting criteria for the PACR from 47 hospitals in the Pediatric Health Information database from January to December 2014. We built four nested regression models by sequentially adding risk adjustment factors as follows: chronic condition indicators (CCIs); PACR patient factors (age and sex); electronic health record-derived SDH (race, ethnicity, payer), and zip code-linked SDH (families below poverty level, vacant housing units, adults without a high school diploma, single-parent households, median household income, unemployment rate). For each model, we measured the change in hospitals' readmission decile-rank and assessed model fit and accuracy.
resultsFor the 458 686 discharges meeting PACR inclusion criteria, in multivariable models, factors associated with higher discharge-level PACR measure included age <1 year, female sex, 1 of 17 CCIs, higher CCI count, Medicaid insurance, higher median household income, and higher percentage of single-parent households. Adjustment for SDH made small but significant improvements in fit and accuracy of discharge-level PACR models, with larger effect at the hospital level, changing decile-rank for 17 of 47 hospitals.
conclusionsWe found that risk adjustment for SDH changed hospitals' readmissions rate rank order. Hospital-level changes in relative readmissions performance can have considerable financial implications; thus, for pay for performance measures calculated at the hospital level, and for research associated therewith, our findings support the inclusion of SDH variables in risk adjustment.
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