Hospital readmission and parent perceptions of their child's hospital discharge

Abstract

Objective: To describe parent perceptions of their child's hospital discharge and assess the relationship between these perceptions and hospital readmission.

Design: A prospective study of parents surveyed with questions adapted from the care transitions measure, an adult survey that assesses components of discharge care. Participant answers, scored on a 5-point Likert scale, were compared between children who did and did not experience a readmission using a Fisher's exact test and logistic regression that accounted for patient characteristics associated with increased readmission risk, including complex chronic condition and assistance with medical technology.

Setting: A tertiary-care children's hospital.

Participants: A total of 348 parents surveyed following their child's hospital discharge between March and October 2010.

Intervention: None.

Main outcome measure: Unplanned readmission within 30 days of discharge.

Results: There were 28 children (8.1%) who experienced a readmission. Children had a lower readmission rate (4.4 vs. 11.3%, P = 0.004) and lower adjusted readmission likelihood [odds ratio 0.2 (95% confidence interval 0.1, 0.6)] when their parents strongly agreed (n = 206) with the statement, 'I felt that my child was healthy enough to leave the hospital' from the index admission. Parent perceptions relating to care management responsibilities, medications, written discharge plan, warning signs and symptoms to watch for and primary care follow-up were not associated with readmission risk in multivariate analysis.

Conclusions: Parent perception of their child's health at discharge was associated with the risk of a subsequent, unplanned readmission. Addressing concerns with this perception prior to hospital discharge may help mitigate readmission risk in children.

Keywords: care transition; children; hospital discharge; quality of care; readmission.

Figure 1

Parent perceptions of their child's health and discharge planning that differed between patients readmitted and not readmitted within 30 days. This figure presents the answers to the three parent perceptions that were significantly (P < 0.05) different between children readmitted and not readmitted. The percent distribution of answers on the 5-point Likert scale is shown for each perception.