Approximately one-fifth of pediatric epilepsy hospital readmissions, many of which occur within 7 days of index discharge, are preventable, according to the findings of a research paper published in Pediatric Neurology.

A collaborative, interdisciplinary team from a tertiary care, free-standing children’s hospital was established to review 30-day readmission data of admitted epilepsy patients. The team was comprised of inpatient and outpatient neuroscience nurses, care managers, a quality outcomes manager, and pediatric neurologists.

Collected data included the day of index discharge, day of readmission, index and readmission length of stay, number of days between initial discharge and readmission, initial admission team, and readmission team. The time frame for admission analysis was May 2014 to October 2016.

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During the 30-month study period, the all-cause 30-day readmission rate was 219 pediatric epilepsy readmissions (8.0%). Of the 21.5% readmissions that were scheduled, up to 37%, 9.6%, and 14.6% were for progression of chronic epilepsy, recently diagnosed epilepsy, and unrelated diagnoses, respectively.

While 64.8% of readmissions were unavoidable, 21.5% of pediatric readmissions were considered preventable. Approximately 35% of readmissions also occurred within a 7 days of initial hospital discharge and 61.7% of these were considered preventable. Issues with the discharge care plan or medication were the most frequently reported causes of preventable readmissions.

Study limitations were the inclusion of patients from a single center as well as the variability in how readmissions were classified, which may have reduced the generalizability of the findings across other centers.

“We believe that all readmissions are potentially preventable and that it is worthwhile for child neurologists to review readmissions,” the researchers wrote. “Focusing on 7-day readmissions should allow providers to examine the majority of preventable readmissions.”

Reference

Vawter-Lee M, Lutley A, Lake SW, et al. Pediatric epilepsy readmissions: the who, when, and why [published online December 25, 2018]. Pediatr Neurol. doi:10.1016/j.pediatrneurol.2018.12.007