467 - Trends in Hospital Readmissions and Emergency Department Visits Following NICU Discharge

Poster Number: 467
Publication Number: 467.130

Aaron M. Germain, Johns Hopkins All Children's Hospital, Tampa, FL, United States; Jeane McCarthy, Johns Hopkins All Children's Hospital, St. Petersburg, FL, United States

Background: Beginning in 2020, various efforts to contain the widespread transmission of respiratory viruses were implemented, including social distancing and masking. Several recent studies have reported possible impacts on pediatric healthcare utilization, including hospitalization rates and emergency department (ED) assessments.

Objective: Describe recent trends in hospital readmissions and ED visits following NICU discharge.

Design/Methods: EMR of discharges from a Children’s Hospital Level IV NICU between January 1, 2013, and December 31, 2021, were assessed for hospital readmission within 30 days of discharge. Days-to-readmission were assessed. ED visits within 14 days of discharge which did not result in hospital readmission were assessed. Indications for hospital readmission and for ED visits were assessed.

Results: 9,643 NICU discharges were reviewed (Table 1). The 30-day readmission rate averaged 3.8% (3.3-4.5%) between 2013- 2019. The 30-day readmission rate decreased to 2.5% in 2020 and returned to baseline at 3.6% in 2021. ED visits within 14 days of discharge averaged 3.9% (3.2-4.5%) between 2013-2019. ED visits within 14 days of discharge decreased to 2.7% in 2020 and returned to baseline at 4.3% in 2021. Diagnosed viral infections comprised 18.3% [11.7%-22.5%] of 30-day readmissions or other ED visits within 14 days of discharge between 2013-2019. Diagnosed viral infections comprised 12.5% of 30-day readmissions or other ED visits within 14 days of discharge in 2020 and 12.9% in 2021. The most common viral infections identified were RSV, Rhinovirus, and parainfluenza virus.Conclusion(s): A trend toward decreased utilization of ED services and toward decreased hospital readmission of recent NICU discharges was observed in year 2020, returning to historical baseline in 2021. A decreased incidence of diagnosed viral infection was observed in 2020 and 2021.  The authors speculate that these trends may correspond in part to the widespread state-mandated adoption of infection prevention and personal protection measures, including social distancing and masking, and the subsequent relaxation of many of these policies. Findings may also correspond with periodic increased public concern for infectious risks in the ED setting, resulting in utilization of alternative sources of medical attention such as outpatient clinics.
Table 1: NICU Discharge Hospital Readmissions Within 30 days, ER Visits Within 14 Days