Identifying high-risk patients for paediatric unplanned readmissions: insights from a Western Sydney hospital

Aim: To identify factors and diagnoses associated with unplanned readmission of paediatric patients to a Western Sydney metropolitan hospital. Method: A retrospective cross-sectional study on paediatric patients admitted to a non-tertiary hospital in Western Sydney from January 2017 to December 2022. Multivariate modelling was used to determine demographic factors and diagnoses associated with unplanned readmission. Results: 1334 (6.3%) of 21 262 admissions had an unplanned readmission within 28 days of the initial admission. Being First Nations had an OR of 1.31 (95% CI 1.11-1.54), while each additional day of admission had an OR of 1.05 (95% CI 1.03-1.07). Increasing age had an OR of 0.95 (95% CI 0.93-0.96) per year, and those admitted during the COVID pandemic had an OR of 0.61 (95% CI 0.54-0.69). A diagnosis of diabetes was found to have an OR of 2.36 (95% CI 1.45-3.84) and bronchiolitis an OR of 1.9 (95% CI 1.53-2.36), whereas a diagnosis of injury had an OR of 0.76 (95% CI 0.58-0.99) and otitis media an OR of 0.23 (95% CI 0.11-0.49). Conclusions: Being First Nations and having a longer length of stay increased the likelihood of unplanned readmission in paediatric patients, while older age and admission during the COVID pandemic decreased the likelihood. A diagnosis of diabetes or bronchiolitis, among others, increased the likelihood of unplanned readmission. Conversely, a diagnosis of injury or otitis media decreased the likelihood of unplanned readmission. This lays the groundwork for further research and targeted interventions to reduce unplanned readmissions and associated costs.