Racial and Ethnic Differences in Pediatric Readmissions for Common Chronic Conditions

Kavita Parikh, Jay Berry, Matt Hall, Grant M. Mussman, Amanda Montalbano, Joanna Thomson, Rustin Morse, Karen M. Wilson, Samir S. Shah

Research output: Contribution to journalArticle

10 Scopus citations

Abstract

Objective To compare the timing and magnitude of variation of pediatric readmission rates across race/ethnicity for selected chronic conditions: asthma, diabetes, seizures, migraines, and depression. Study design Retrospective analysis of hospitalizations at 48 children's hospitals in the 2013 Pediatric Health Information System database for children (ages 0-18 years) admitted for asthma (n = 36 910), seizure (n = 35 361), diabetes (n = 12 468), migraine (n = 5882), and depression (n = 5132). Generalized linear models with a random effect for hospital were used to compare the likelihood of readmission by patients' race/ethnicity, adjusting for severity of illness, age, payer, and medical complexity. Adjusted readmission rates were calculated by week over 1 year. Results Significant variation in adjusted readmission rates by race/ethnicity existed for conditions aside from depression. Disparities for diabetes and asthma emerged at 3 and 4 weeks, respectively; they remained divergent up to 1 year with the highest 1-year readmission rates in non-Hispanic blacks vs other race/ethnicities (diabetes: 21.7% vs 13.4%, P < .001; asthma: 21.4% vs 14.6%, P < .001). Disparities for migraines and seizure emerged at 6 and 7 weeks, respectively; they remained up to 1 year, with the highest 1-year readmission rates in non-Hispanic whites vs other race/ethnicities (migraine: 17.3% vs 13.6%, P < .001; seizure: 23.9% vs 21.9%, P < .001). Conclusions Readmission disparities behave differently across chronic conditions. They emerge more quickly after discharge for children hospitalized with asthma or diabetes than for seizures or migraines. The highest readmission rates were not consistently observed for 1 particular race/ethnicity. Study findings can impact pediatric chronic disease management to improve care for children with these conditions.

Original languageEnglish (US)
Pages (from-to)158-164.e1
JournalJournal of Pediatrics
Volume186
DOIs
StatePublished - Jul 1 2017

Keywords

  • asthma
  • children
  • depression
  • diabetes
  • migraine
  • pediatrics
  • readmissions
  • seizures

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Parikh, K., Berry, J., Hall, M., Mussman, G. M., Montalbano, A., Thomson, J., Morse, R., Wilson, K. M., & Shah, S. S. (2017). Racial and Ethnic Differences in Pediatric Readmissions for Common Chronic Conditions. Journal of Pediatrics, 186, 158-164.e1. https://doi.org/10.1016/j.jpeds.2017.03.046