The Affordable Care Act penalizes hospitals with high readmission rates. Children’s hospitals are not yet among these hospitals, although that is likely to change. Because chronic neurologic conditions represent a sizable proportion of all children’s hospitals costs, and because some/many of the readmissions might not be easily prevented, children’s hospitals and neurologists who care for children might be inappropriately penalized for some readmissions. We encourage more study to identify the correlates of readmission of children who have a neurologic disorder.
Provisions in the Affordable Care Act that relate to PSOs and reducing unnecessary readmissions. Agency for Healthcare Research and Quality. http://www.pso.ahrq.gov/readmin/psoaca.htm. Accessed October 23, 2012.
4.
BerryJGToomeySLZaslavskyAM. Pediatric readmission prevalence and variability across hospitals. J Am Med Assoc. 2013;309:372–380.
5.
van WalravenCBennettCJenningsA. Proportion of hospital readmissions deemed avoidable: a systematic review. Can Med Assoc J. 2011;183:E391–E402.
6.
van WalravenCJenningsATaljaardM. Incidence of potentially avoidable urgent readmissions and their relation to all-cause urgent readmissions. Can Med Assoc J. 2011;183:E1067–E1072.
7.
ChenEBloombergGRFisherEBJr. Predictors of repeat hospitalizations in children with asthma: the role of psychosocial and socioenvironmental factors. Health Psychol. 2003;22:12–18.
8.
ChandlerT. Reducing re-admission for asthma: impact of a nurse-led service. Paediatr Nurs. 2007;19:19–21.
9.
LiuSYPearlmanDN. Hospital readmissions for childhood asthma: the role of individual and neighborhood factors. Public Health Rep. 2009;124:65–78.
10.
MorseRBHallMFieldstonES. Hospital-level compliance with asthma care quality measures at children's hospitals and subsequent asthma-related outcomes. J Am Med Assoc. 2011;306:1454–1460.
11.
BrousseauDCOwensPLMossoAL. Acute care utilization and rehospitalizations for sickle cell disease. J Am Med Assoc. 2010;303:1288–1294.
12.
JencksSFWilliamsMVColemanEA. Rehospitalizations among patients in the Medicare fee-for-service program. N Engl J Med. 2009;360:1418–1428.
13.
SobotaAGrahamDANeufeldEJ. Thirty-day readmission rates following hospitalization for pediatric sickle cell crisis at freestanding children's hospitals: risk factors and hospital variation. Pediatr Blood Cancer. 2012;58:61–65.
14.
ForthmanMTGoldRSDoveHG. Risk-adjusted indices for measuring the quality of inpatient care. Qual Manag Health Care. 2010;19:265–277.
15.
BerryJGHallDEKuoDZ. Hospital utilization and characteristics of patients experiencing recurrent readmissions within children's hospitals. J Am Med Assoc. 2011;305:682–690.
16.
AujeskyDMorMKGengM. Predictors of early hospital readmission after acute pulmonary embolism. Arch Intern Med. 2009;169:287–293.
17.
JackBWChettyVKAnthonyD. A reengineered hospital discharge program to decrease rehospitalization: a randomized trial. Ann Intern Med. 2009;150:178–187.
18.
JoyntKEOravEJJhaAK. Thirty-day readmission rates for Medicare beneficiaries by race and site of care. J Am Med Assoc. 2011;305:675–681.
19.
CampbellSESeymourDGPrimroseWR. A systematic literature review of factors affecting outcome in older medical patients admitted to hospital. Age Ageing. 2004;33:110–115.
20.
Rodriguez-ArtalejoFGuallar-CastillonPHerreraMC. Social network as a predictor of hospital readmission and mortality among older patients with heart failure. J Card Fail. 2006;12:621–627.
21.
KarthaAAnthonyDManassehCS. Depression is a risk factor for rehospitalization in medical inpatients. Prim Care Companion J Clin Psychiatry. 2007;9:256–262.
22.
ChabraAChavezGFAdamsEJ. Characteristics of children having multiple Medicaid-paid asthma hospitalizations. Matern Child Health J. 1998;2:223–229.
23.
MinkovitzCSAndrewsJSSerwintJR. Rehospitalization of children with asthma. Arch Pediatr Adolesc Med. 1999;153:727–730.
24.
WallaceJCDenkCEKruseLK. Pediatric hospitalizations for asthma: use of a linked file to separate person-level risk and readmission. Prev Chronic Dis. 2004;1:A07.
25.
AshMBrandtS. Disparities in asthma hospitalization in Massachusetts. Am J Public Health. 2006;96:358–362.
26.
LinRYPittTJLouWY. Asthma hospitalization patterns in young children relating to admission age, infection presence, sex, and race. Ann Allergy Asthma Immunol. 2007;98:139–145.
27.
MackieASIonescu-IttuRPiloteL. Hospital readmissions in children with congenital heart disease: a population-based study. Am Heart J. 2008;155:577–584.
28.
BerensonJShihA. Higher readmissions at safety-net hospitals and potential policy solutions. Issue Brief (Commonw Fund). 2012;34:1–16.
29.
BerryJGPoduriABonkowskyJL. Trends in resource utilization by children with neurological impairment in the United States inpatient health care system: a repeat cross-sectional study. PLoS Med. 2012;9:e1001158.
30.
KwanPBrodieMJ. Early identification of refractory epilepsy. N Engl J Med. 2000;342:314–319.
31.
GorodeskiEZStarlingRCBlackstoneEH. Are all readmissions bad readmissions?N Engl J Med. 2010;363:297–298.
32.
WeinbergerMOddoneEZHendersonWG. Does increased access to primary care reduce hospital readmissions? Veterans Affairs Cooperative Study Group on Primary Care and Hospital Readmission. N Engl J Med.1996;334:1441–1447.
33.
BrockJMitchellJIrbyK. Association between quality improvement for care transitions in communities and rehospitalizations among Medicare beneficiaries. J Am Med Assoc. 2013;309:381–391.
34.
SrivastavaRKerenR. Pediatric readmissions as a hospital quality measure. J Am Med Assoc. 2013;309:396–398.
35.
HernandezAFGreinerMAFonarowGC. Relationship between early physician follow-up and 30-day readmission among Medicare beneficiaries hospitalized for heart failure. J Am Med Assoc. 2010;303:1716–1722.
36.
JackBGreenwaldJForsytheS. Developing the tools to administer a comprehensive hospital discharge program: the ReEngineered Discharge (RED) program. In: HenriksenKBattlesJBKeyesMAGradyML, eds. Advances in Patient Safety: New Directions and Alternative Approaches (Vol 3: Performance and Tools). Rockville, MD: Agency for Healthcare Research and Quality; 2008.
