Early Readmission of Newborns in a Large Health Care System
Early Readmission of Newborns in a Large Health Care System
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DOI：
10.1542/peds.2012-2634
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发表时间：
2013-05-01
期刊：
影响因子：
8
通讯作者：
Buchi, Karen F.
中科院分区：
文献类型：
--
作者：
Young, Paul C.;Korgenski, Kent;Buchi, Karen F.
背景技术背景：早期再入院的明显健康的新生儿出院后，从良好的婴儿托儿所（WBN）可能反映了不充分的评估新生儿的准备出院。目的：确定的频率，原因，成本和变化率的早期再住院的新生儿出院21 WBN在1卫生保健系统。方法：我们查询了Intermountain Healthcare（IH）（一家大型犹他州医疗保健系统）的企业数据仓库，以确定2000年至2010年期间从IH WBN出院的胎龄为34至42周的新生儿。我们确定了所有新生儿入院的IH医院在28天内出院，并记录了他们的出生医院，年龄，入院原因（S），住院时间，和住院costs.RESULTS：在研究期间，296 114婴儿出院IH医院WBNs。其中，5308人（17.9/1000）在出院后28天内再次入院。在5308名再次入院的婴儿中，41%有喂养问题，35%有黄疸，33%有呼吸窘迫。大多数有喂养问题和黄疸的新生儿在出生后的前2周内入院。晚期早产儿和早期足月新生儿的再入院率高于足月儿。有显着的变化，在21家医院出生的新生儿再入院率在IH system.CONCLUSIONS：潜在的可预防的条件，包括喂养问题和黄疸，占大多数新生儿早期再入院。晚期早产儿和早期足月新生儿的再入院率较高，应评估与早期再入院相关的其他因素。
BACKGROUND: Early readmissions of apparently healthy newborns after discharge from well baby nurseries (WBN) may reflect an in-adequate assessment of the newborn's readiness for discharge.OBJECTIVE: To determine the frequency, causes, costs, and variations in rates of early rehospitalization of newborns discharged from 21 WBNs in 1 health care system.METHODS: We queried the Enterprise Data Warehouse of Intermountain Healthcare (IH), a large Utah health care system, to identify newborns with gestational ages of 34 to 42 weeks discharged from an IH WBN between 2000 and 2010. We identified all newborns admitted to an IH hospital within 28 days of discharge and recorded their birth hospital, age, reason(s) for admission, length of stay, and inpatient costs.RESULTS: During the study period, 296 114 infants were discharged from IH hospital WBNs. Of these, 5308 (17.9/1000) were readmitted within 28 days of discharge. Of the 5308 infants who were readmitted, 41% had feeding problems, 35% had jaundice, and 33% had respiratory distress. The majority of newborns with feeding problems and jaundice were admitted in their first 2 weeks of life. Late preterm and early term newborns had higher rates of readmission than term infants. There were significant variations in readmission rates of newborns born at the 21 hospitals in the IH system.CONCLUSIONS: Potentially preventable conditions, including feeding problems and jaundice, account for most early readmissions of newborns. Late preterm and early term newborns have higher rates of readmission and should be assessed for other factors associated with early readmission.