TABLE 4

Factors Rated as Reasons for Readmission

Major CategoriesReasonsExamplen (%), N = 204
Physician-related reasonsPremature discharge before resolution of medical problemDischarged with inadequate oral intake of fluids.7 (3)
Incorrect diagnosis or therapyDischarge diagnosis of transient synovitis. Readmitted with diagnosis of osteomyelitis.25 (12)
Incomplete discharge instructionsMissing anticipatory guidance for when to seek medical attention.2 (1)
Caretaker-related reasonsParental perception of early dischargeSecond admission notes describe that parent felt that patient was sent home too soon or not ready for discharge.3 (1)
Parental perception of incomplete evaluation during previous hospital staySecond admission notes describe specific tests that parents felt should have been performed.1 (<1)
Noncompliance with discharge medicationsPatient refusing to take clindamycin because of poor taste.7 (3)
Disease-related reasonsUnforeseen worsening of disease processInfant with bronchiolitis was breathing comfortably at discharge but returns with respiratory distress.60 (29)
Unforeseen development of a complication of the disease process or treatmentPatient with osteomyelitis is sent home with a PICC line for intravenous antibiotics and returns with a PICC line infection.51 (25)
Recurrence of disease with evidence of improvement after first admissionInfant with grade V vesicoureteral reflux admitted for UTI. Afebrile and eating well at discharge. Readmitted for a second UTI due to different pathogen.67 (33)
UnrelatedDifferent admission diagnosis unrelated to the first admissionDischarged with pneumonia and readmitted for cellulitis.27 (13)
  • PICC, peripherally inserted central catheter; UTI, urinary tract infection.

  • Readmissions with a physician-related or caretaker-related reason for readmission were considered potentially preventable. Because 46 patients had >1 reason for readmission, the sum of percentages exceeds 100%.