Readmission rate as a quality indicator: the risk factors for readmission among patients with childhood asthma

Background: Global management of childhood asthma is suboptimal. With the increasing prevalence of childhood asthma, the poor management of childhood asthma became a huge public health concern and called for urgent actions. To design evidence-based interventions on improving quality of care for patients with childhood asthma, a better understanding is needed of what are the risk factors for readmission among asthmatic patients. Objective: To provide an overview about the justification of readmission rate as a quality indicator for chronic disease management. To review the recent research findings about risk factors for readmission among patients with childhood asthma. Methods: To search PubMed database for articles published in English that contained key words of readmission or re-hospitalization, childhood asthma or asthma for children. Results: Shorter time (within 30 days) readmission rate has more strength of assessing the quality of care at hospitals. On the contrary, 3-month or 1-year readmission rates reflect the effectiveness of care outside of hospitals. The risk factors for readmission among patients with childhood asthma are illustrated at an individual level (i.e. young age, race, and psychosocial stress), interpersonal level (i.e. parents’ perception, parent’s knowledge, family structure, and smoking), community level (i.e. air pollutant, low-income neighborhood), and institutional level (inappropriate treatment at hospital, communication barrier, school regulation). Conclusion: Readmission rates with different time frames have various utilization. More studies are needed to justify readmission within 30 days to assess the quality of care at hospitals. The risk factors for readmission among patients with childhood asthma are complex at an individual, interpersonal, community and institutional level. To gain fully comprehension of the risk factors, more studies are needed. The ideal condition is that all the health care professionals should share the accountability of the long-term care of patients