LAUSR

U nplanned hospital revisits cost society over $1 billion annually in the pediatric healthcare environment alone. The Center for Medicare and Medicaid Services reduces payments to hospitals with high revisit rates to incentivize quality care and mitigate this financial burden. In this article, the authors propose a framework to lessen the financial losses associated with revisits. The framework helps prioritize revisit prevention efforts for various pediatric conditions based on the condition’s unplanned revisit rate and its relative contribution to hospital length of stay burden. To create this framework, a retrospective cohort analysis was performed using the Pediatric Health Information System database. The 30-day revisit rate for 159,675 encounters was analyzed. This study includes unplanned inpatient readmissions and emergency department revisits for the 30 most commonly performed general pediatric procedures. The study elucidates how a large amount of resources for revisits was being utilized on a comparatively small number of conditions and procedures. Gastrostomy, appendectomy for complicated appendicitis, fundoplication, and reflux procedures have high revisit rates and burden and should thus be prioritized for prevention efforts. To reduce negative outcomes from unplanned revisits, hospitals must know which cases to focus their revisit prevention efforts on. By adopting this framework, hospitals can identify where preventative efforts would be most advantageous for them. This provides both fiscal benefits and better patient outcomes.