Factors Related to Pediatric Readmissions of Four Major Diagnostic Categories in Hawai`i.

Readmissions are a key quality measure for health care decision making and understanding variables associated with readmissions has become a crucial research area. This study identified patient-level factors that might be associated with pediatric readmissions using a database that included inpatient data from 2008 to 2017 from Hawai`i. Four major diagnostic categories with the most pediatric readmissions in the state were identified: respiratory, digestive, mental, and nervous system diseases and disorders. The associations between readmission and patient-level variables, such as age, sex, race/ethnicity, insurance status, and Charlson Comorbidity Index (CCI), were determined for each diagnosis and for overall readmissions. CCI and insurance were the strongest predictors when all diagnoses were combined. However, for some diagnoses, there was weak or no association between CCI, insurance, and readmission. This suggests that diagnosis-specific analysis of predictors of readmission may be more useful than looking at predictors of readmission for all diagnoses combined. While this study focused on patient variables, future studies should also incorporate how hospital variables may also be related to diagnosis.