Background and aims
Readmissions of children in hospitals are a potentially preventable problem. Reducing the number of preventable readmissions benefits the children and their families, and a low readmission incidence is an important indicator in quality of care. Studies on preventable readmissions report incidences varying between 25% and 47%, but research in pediatrics is limited. Therefore, we investigated the incidence in different age groups and possible reasons of preventable readmissions on five pediatric wards.

Method
All clinical readmissions in 2016 were included in this study. The primary outcome was preventable readmission. Two investigators independently explored the patients’ files using a predefined checklist based on predictive factors known from the literature and finalized in an expert meeting. A third researcher was consulted in case of disagreement. The interrater reliability was excellent (k=0.91). Possible reasons of the preventable readmissions where categorized according the items of the checklist. 

Results
In 2016 there was a total of 4437 admissions. The number of readmissions was 218 (4.9%) and 43 (19.8%) were considered preventable. The incidences in age groups varied: infants (19.8%), toddles (18.6%), pre-school children (15%), school-aged children (18.8%) and adolescents (22.7%). These differences were not statistically significant (p=0.95). Reasons for the readmissions appeared to be ineffective discharge procedures, deviating signs and symptoms shortly before discharge, inadequate communication and an ineffective shared-decision making with teenagers and adolescents.  

Conclusion
The incidence of preventable readmissions of 19.8% stresses the need for improvements. Solutions might be found in improving discharge policies and communication within pediatric age groups.

PREVENTABLE READMISSIONS OF CHILDREN: A CHALLENGE TO REDUCE!