WHAT'S KNOWN ON THIS SUBJECT: Pneumonia is a leading cause of hospitalization among children, and readmissions after discharge are common.WHAT THIS STUDY ADDS: Eight percent of children experience a readmission within 30 days after hospital discharge for pneumonia. Readmissions are most common among young children and those with chronic medical conditions, and are associated with substantial costs. abstract BACKGROUND AND OBJECTIVES: Pneumonia is a leading cause of hospitalization and readmission in children. Understanding the patient characteristics associated with pneumonia readmissions is necessary to inform interventions to reduce avoidable hospitalizations and related costs. The objective of this study was to characterize readmission rates, and identify factors and costs associated with readmission among children previously hospitalized with pneumonia. METHODS:Retrospective cohort study of children hospitalized with pneumonia at the 43 hospitals included in the Pediatric Health Information System between January 1, 2008, and December 31, 2011. The primary outcome was all-cause readmission within 30 days after hospital discharge, and the secondary outcome was pneumonia-specific readmission. We used multivariable regression models to identify patient and hospital characteristics and costs associated with readmission. RESULTS:A total of 82 566 children were hospitalized with pneumonia (median age, 3 years; interquartile range 1-7). Thirty-day all-cause and pneumonia-specific readmission rates were 7.7% and 3.1%, respectively. Readmission rates were higher among children ,1 year of age, as well as in patients with previous hospitalizations, longer index hospitalizations, and complicated pneumonia. Children with chronic medical conditions were more likely to experience all-cause (odds ratio 3.0; 95% confidence interval 2.8-3.2) and pneumonia-specific readmission (odds ratio 1.8; 95% confidence interval 1.7-2.0) compared with children without chronic medical conditions. The median cost of a readmission ($11 344) was higher than that of an index admission ($4495; P = .01). Readmissions occurred in 8% of pneumonia hospitalizations but accounted for 16.3% of total costs for all pneumonia hospitalizations. CONCLUSIONS:Readmissions are common after hospitalization for pneumonia, especially among young children and those with chronic medical conditions, and are associated with substantial costs. Hospital readmissions account for a large proportion of health care expenditures. 1 Readmission rates have been proposed as a marker of the quality of hospital care, and state and federal agencies have imposed financial penalties on institutions with high rates of readmission. 2 Although efforts to reduce readmissions have focused on chronic medical conditions, acute conditions account for a large proportion of readmissions in children. 3 Pneumonia is a leading cause of hospitalization among children, and readmissions after discharge are common. 3,4 A better understanding of the patient and hospital characteristics associated w...

Among children without comorbidities hospitalized with CAP in a non-ICU setting, the rate of bacteremia was low, and isolated pathogens were usually susceptible to penicillin. Blood cultures may not be needed for most children hospitalized with CAP.

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