Factors Rated as Reasons for Readmission
| Major Categories | Reasons | Example | n (%), N = 204 |
|---|---|---|---|
| Physician-related reasons | Premature discharge before resolution of medical problem | Discharged with inadequate oral intake of fluids. | 7 (3) |
| Incorrect diagnosis or therapy | Discharge diagnosis of transient synovitis. Readmitted with diagnosis of osteomyelitis. | 25 (12) | |
| Incomplete discharge instructions | Missing anticipatory guidance for when to seek medical attention. | 2 (1) | |
| Caretaker-related reasons | Parental perception of early discharge | Second 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 stay | Second admission notes describe specific tests that parents felt should have been performed. | 1 (<1) | |
| Noncompliance with discharge medications | Patient refusing to take clindamycin because of poor taste. | 7 (3) | |
| Disease-related reasons | Unforeseen worsening of disease process | Infant with bronchiolitis was breathing comfortably at discharge but returns with respiratory distress. | 60 (29) |
| Unforeseen development of a complication of the disease process or treatment | Patient 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 admission | Infant 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) | |
| Unrelated | Different admission diagnosis unrelated to the first admission | Discharged 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%.