ArticleJournal of hospital medicine2019
Discharge Medical Complexity, Change in Medical Complexity and Pediatric 30-day Readmission.
Article in Journal of hospital medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Trust-building in pediatric hospital medicine discharge.Journal of hospital medicine · 2026Article
- Discharge against medical advice among pediatric patients: A retrospective study from a Saudi tertiary emergency department.Saudi medical journal · 2025Article
- Readmission Rates After Acute Respiratory Distress Syndrome in Children.JAMA network open · 2023Article
- Comparing two definitions of pediatric complexity among children cared for in general and pediatric emergency departments in a statewide sample.Journal of the American College of Emergency Physicians open · 2023Article
- Resources and Costs Associated With Repeated Admissions to PICUs.Critical care explorations · 2021Article
- Counting the Ways to Count Medications: The Challenges of Defining Pediatric Polypharmacy.Journal of hospital medicine · 2019Article
- Discharge against medical advice in pediatrics: a 10-year retrospective analysis in a tertiary care center.Annals of Saudi medicineArticle
- Unplanned Readmissions in Children with Medical Complexity in Saudi Arabia: A Large Multicenter Study.Saudi journal of medicine & medical sciencesArticle
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Authors and funding
9 authors.
Funding
Abstract
backgroundWhile medical complexity is associated with pediatric readmission risk, less is known about how increases in medical complexity during hospitalization affect readmission risk.
methodsWe conducted a five-year retrospective, case-control study of pediatric hospitalizations at a tertiary care children's hospital. Cases with a 30-day unplanned readmission were matched to controls based on admission seasonality and distance from the hospital. Complexity variables included the number of medications prescribed at discharge, medical technology, and the need for home healthcare services. Change in medical complexity variables included new complex chronic conditions and new medical technology. We estimated odds of 30-day unplanned readmission using adjusted conditional logistic regression.
resultsOf 41,422 eligible index hospitalizations, we included 595 case and 595 control hospitalizations. Complexity: Polypharmacy after discharge was common. In adjusted analyses, being discharged with ≥2 medications was associated with higher odds of readmission compared with being discharged without medication; children with ≥5 discharge medications had a greater than four-fold higher odds of readmission. Children assisted by technology had higher odds of readmission compared with children without technology assistance. Change in complexity: New diagnosis of a complex chronic condition (Adjusted Odds Ratio (AOR) = 1.75; 1.11-2.75) and new technology (AOR = 1.84; 1.09-3.10) were associated with higher risk of readmission when adjusting for patient characteristics. However, these associations were not statistically significant when adjusting for length of stay.
conclusionPolypharmacy and use of technology at discharge pose a substantial readmission risk for children. However, added technology and new complex chronic conditions do not increase risk when accounting for length of stay.
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