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确定儿童30天再入院的患病率及原因:来自一家三级儿科医院的案例研究

Identifying the Prevalence and Causes of 30-Day Hospital Readmission in Children: A Case Study from a Tertiary Pediatric Hospital.

作者信息

AlKhalaf Hamad, AlHamdan Wejdan, Kinani Sondos, AlZighaibi Reema, Fallata Shahd, Al Mutrafy Abdullah, Alqanatish Jubran

机构信息

Department of Pediatrics, King Abdullah Specialized Children's Hospital, Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia.

King Abdullah International Medical Research Center, Riyadh, Saudi Arabia.

出版信息

Glob J Qual Saf Healthc. 2023 Nov 24;6(4):101-110. doi: 10.36401/JQSH-23-17. eCollection 2023 Nov.

Abstract

INTRODUCTION

The objectives of this study were to determine the prevalence of unplanned readmissions in the pediatric population within 30 days of discharge, identify the possible reasons behind them, and develop a predictive model for unplanned admissions.

METHODS

A retrospective chart review study of 25,211 patients was conducted to identify the prevalence of readmissions occurring within 30 days of discharge from the King Abdullah Specialized Children's Hospital (KASCH) in Riyadh, Saudi Arabia, between Jan 1, 2019, and Dec 31, 2021. The data were collected using the BestCare electronic health records system and analyzed using Jamovi statistical software version 1.6.

RESULTS

Among the 25,211 patients admitted to the hospital during the study period, the prevalence of unplanned readmission within 30 days was 1291 (5.12%). Of the 1291 patients, 1.91% had subsequent unplanned readmissions. In 57.8% of the cases, the cause of the first unplanned readmission was related to the cause of the first admission, and in 90.64% of the cases, the cause of the subsequent unplanned readmission was related to the cause of the first unplanned readmission. The most common reason for the first unplanned readmission was postoperative complications (18.75%), whereas pneumonia (10.81%) was the most common reason for subsequent unplanned readmissions. Most patients with subsequent unplanned readmissions were also found to have either isolated central nervous system pathology or chronic complex medical conditions.

CONCLUSION

Internationally, the rate of unplanned readmissions in pediatric patients has been estimated to be 6.5% within 30 days, which is comparable to the results of our study (5.12%). Most of the causes of first and subsequent unplanned readmission were found to be related to primary admission. The diagnosis/causes of readmission vary depending on the patient's age. A predictive model for pediatric readmission should be established so that preventive measures can be implemented.

摘要

引言

本研究的目的是确定儿科患者出院后30天内非计划再入院的发生率,找出其背后的可能原因,并开发一个非计划再入院的预测模型。

方法

对25211例患者进行回顾性病历审查研究,以确定2019年1月1日至2021年12月31日期间沙特阿拉伯利雅得阿卜杜拉国王专科医院(KASCH)出院后30天内再入院的发生率。数据通过BestCare电子健康记录系统收集,并使用Jamovi统计软件1.6版进行分析。

结果

在研究期间入院的25211例患者中,30天内非计划再入院的发生率为1291例(5.12%)。在这1291例患者中,1.91%有后续非计划再入院情况。在57.8%的病例中,首次非计划再入院的原因与首次入院的原因相关,在90.64%的病例中,后续非计划再入院的原因与首次非计划再入院的原因相关。首次非计划再入院最常见的原因是术后并发症(18.75%),而肺炎(10.81%)是后续非计划再入院最常见的原因。大多数有后续非计划再入院情况的患者还被发现患有孤立的中枢神经系统病变或慢性复杂疾病。

结论

在国际上,儿科患者30天内非计划再入院率估计为6.5%,这与我们的研究结果(5.12%)相当。首次和后续非计划再入院的大多数原因都与初次入院有关。再入院的诊断/原因因患者年龄而异。应建立儿科再入院的预测模型,以便实施预防措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e02/10887476/7cd9cff29ee1/i2589-9449-6-4-101-f01.jpg

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