+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Hospital readmission after management of appendicitis at freestanding children's hospitals: contemporary trends and financial implications



Hospital readmission after management of appendicitis at freestanding children's hospitals: contemporary trends and financial implications



Journal of Pediatric Surgery 47(6): 1170-1176



The purpose of this study was to characterize epidemiologic trends and cost implications of hospital readmission after treatment of pediatric appendicitis. We conducted a 5-year retrospective cohort analysis of 30-day readmission rates for 52,054 patients admitted with appendicitis at 38 children's hospitals participating in the Pediatric Health Information System database. Patients were categorized as "uncomplicated" (postoperative length of stay [LOS] ≤ 2 days) or "complicated" (LOS ≥ 3 days and ≥ 4 consecutive days of antibiotics) and analyzed for demographic data, treatment received during the index admission, readmission rates, and excess LOS and hospital-related costs attributable to readmission encounters. The aggregate 30-day readmission rate was 8.7%, and this varied significantly by disease severity and management approach (uncomplicated appendectomy, 5.6%; complicated appendectomy, 12.8%; drainage, 22.6%; antibiotics only, 24.6%; P < .0001). The median hospital cost per case attributable to readmission was $3401 (reflecting a 44% relative increase in cumulative treatment-related cost), and this varied significantly by disease severity and management approach (uncomplicated appendectomy, $1946 [31% relative increase]; complicated appendectomy, $6524 [53% increase]; drainage, $6827 [48% increase]; antibiotics only, $5835 [58% increase]; P < .0001). In freestanding children's hospitals, readmission after treatment of pediatric appendicitis is a relatively common and costly occurrence. Collaborative efforts are needed to characterize patient, treatment, and hospital-related risk factors as a basis for developing preventative strategies.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 036456764

Download citation: RISBibTeXText

PMID: 22703789

DOI: 10.1016/j.jpedsurg.2012.03.025


Related references

Variation in practice and resource utilization associated with the diagnosis and management of appendicitis at freestanding children's hospitals: implications for value-based comparative analysis. Annals of Surgery 259(6): 1228-1234, 2014

Relationship between unplanned readmission and total treatment-related hospital days following management of complicated appendicitis at 31 children's hospitals. Journal of Pediatric Surgery 48(6): 1389-1394, 2014

Thirty-day readmission rates following hospitalization for pediatric sickle cell crisis at freestanding children's hospitals: risk factors and hospital variation. Pediatric Blood and Cancer 58(1): 61-65, 2012

The Financial Impact of an Avoided Readmission for Teaching and Safety-Net Hospitals Under Medicare's Hospital Readmission Reduction Program. Medical Care Research and Review 2018: 1077558718795733, 2018

Variation in risk-adjusted hospital readmission after treatment of appendicitis at 38 children's hospitals: an opportunity for collaborative quality improvement. Annals of Surgery 257(4): 758-765, 2013

Trends in readmission rates for safety net hospitals and non-safety net hospitals in the era of the US Hospital Readmission Reduction Program: a retrospective time series analysis using Medicare administrative claims data from 2008 to 2015. Bmj Open 7(7): E016149, 2018

Contemporary use of nephron-sparing surgery for children with malignant renal tumors at freestanding children's hospitals. Urology 78(2): 422-426, 2011

Children with appendicitis on the US-Mexico border have socioeconomic challenges and are best served by a freestanding children's hospital. Pediatric Surgery International 34(12): 1269-1280, 2018

Financial Implications of Hospital Readmission After Hip Fracture. Geriatric Orthopaedic Surgery and Rehabilitation 6(3): 140-146, 2015

Children with Appendicitis on the US-Mexico Border Are Socioeconomically Disadvantaged and Best Served by a Freestanding Childrens Hospital. Journal of the American College of Surgeons 225(4): S99-S100, 2017

Implications of the growing use of freestanding children's hospitals. JAMA Pediatrics 167(2): 190-192, 2013

Management and outcomes for children with acute appendicitis differ by hospital type: areas for improvement at public hospitals. Clinical Pediatrics 48(5): 499-504, 2009

Comparison of the change in heart failure readmission and mortality rates between hospitals subject to hospital readmission reduction program penalties and critical access hospitals. American Heart Journal 209: 63-67, 2019

Invited commentary: financial implications of early hospital discharge and readmission. Surgery 132(1): 16-16, 2002

Comparative Trends in Payment Adjustments Between Safety-Net and Other Hospitals Since the Introduction of the Hospital Readmission Reduction Program and Value-Based Purchasing. JAMA 317(15): 1578-1580, 2017