Maturational, comorbid, maternal and discharge domain impact on preterm rehospitalizations: a comparison of planned and unplanned rehospitalizations

Objective: To determine the predictive value of (1) maternal, (2) maturational, (3) comorbid and (4) discharge domains associated with preterm infant rehospitalization. Study Design: Retrospective, cohort study of preterm infants discharged home from a level IV neonatal intensive care unit. Rates of...

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Bibliographic Details
Published in:Journal of perinatology 2016-04, Vol.36 (4), p.317-324
Main Authors: Schell, S, Kase, J S, Parvez, B, Shah, S I, Meng, H, Grzybowski, M, Brumberg, H L
Format: Article
Language:English
Subjects:
692/499
692/700/228
Adult
Analysis
Comorbidity
Comparative analysis
Discharge
Domains
Female
Health aspects
Hospital admission and discharge
Humans
Infant
Infant, Newborn
Infant, Premature
Infants
Intensive Care Units, Neonatal
Male
Medicine
Medicine & Public Health
Mothers
Neonates
original-article
Patient Discharge - statistics & numerical data
Patient Readmission - statistics & numerical data
Pediatric Surgery
Pediatrics
Premature babies
Premature infants
Quality Improvement
Retrospective Studies
Risk Factors
Socioeconomic Factors
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Summary:Objective: To determine the predictive value of (1) maternal, (2) maturational, (3) comorbid and (4) discharge domains associated with preterm infant rehospitalization. Study Design: Retrospective, cohort study of preterm infants discharged home from a level IV neonatal intensive care unit. Rates of unplanned and planned 6-month readmissions were assessed. The four domains were modeled incrementally and separately to predict relative and combined contributions to the readmission risk. Result: Out of 504 infants, 5% had 30-day readmissions (22 unplanned, three planned). By 6 months, 13% were rehospitalized (52 unplanned, 15 planned). Sixty-seven infants had 96 readmission events with 30% of readmission events elective. The four domains together predicted 78% of total 1-month, all 6-month and unplanned 6-month readmissions. Discharge complexity was as predictive as comorbidity in all models. Conclusion: These four-domain models were more predictive than single domains. Many total readmission events were planned, suggesting parsing planned and unplanned rehospitalizations may benefit quality-improvement efforts.
ISSN:0743-8346
1476-5543
DOI:10.1038/jp.2015.194