Technical Note: 30-Day Pediatric Readmission Rate

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2.10 30-Day Pediatric Readmission Rate

Unit of Analysis

The unit of analysis is an episode of care. An episode of care refers to all contiguous in-patient hospitalizations and same-day surgery visits. For episodes with transfers within or between facilities, transactions were linked regardless of diagnoses. To construct an episode of care, a transfer is assumed to have occurred if either of the following conditions is met:

  • An acute care hospitalization or a same day surgery visit occurs within six hours of discharge from the previous acute care hospitalization or same day surgery visit, regardless of whether the transfer is coded;
  • An acute care hospitalization or same day surgery visit occurs within 6-12 hours of discharge from the previous acute care hospitalization or same day surgery visit, and at least one of the hospitalizations or visits has coded the transfer.
Denominator (Index Episode)

Please refer to the flowchart (Appendix IV) for an illustration.

Inclusion Criteria:

  1. Episodes involving inpatient care. An episode may start or end in a day surgery setting. Episodes that both start and end in day surgery settings are not included.
  2. Age younger than 20 years
  3. Discharge between April 1 and March 1 of the following year (period of case selection ends on March 1 of the following year to allow for 30 days of follow-up)
  4. Sex recorded as male or female
  5. Canadian resident

Exclusion Criteria:

  1. Records with an invalid health card number
  2. Records with an invalid date of birth
  3. Records with an invalid admission date or time
  4. Records with an invalid discharge date or time
  5. Records with admission category of newborn
  6. Records with admission category of stillbirth or cadaveric donor
  7. Episodes with discharge as death or self sign-out
  8. Presence of at least one record in the episode with major clinical category (MCC) 17 (Mental Diseases and Disorders)
  9. Presence of at least one record in the episode with MCC 13 (Pregnancy and Childbirth)
  10. Presence of at least one record in the episode with palliative care (ICD-10-CA: Z51.5) coded as most responsible diagnosis (MRDx)
Numerator

Inclusion Criteria:
 1. Cases within the denominator with an unplanned readmission within 30 days of discharge after the index episode of care
 2. Emergent or urgent (non-elective) readmission to an acute care hospital

Exclusion Criteria:
Presence of at least one record in the episode with one of the following:

  • Delivery (ICD-10-CA: O10–O16, O21–O29, O30–O37, O40–O46, O48, O60–O69, O70–O75, O85–O89, O90–O92, O95, O98, O99 with a sixth digit of 1 or 2; or Z37 recorded in any diagnosis field)
  • Chemotherapy for neoplasm (ICD-10-CA: Z51.1) as MRDx

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