{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T13:26:23Z","timestamp":1791033983442,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2011,6,14]],"date-time":"2011-06-14T00:00:00Z","timestamp":1308009600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Harvard Pediatric Health Services Research Fellowship","award":["AHRQ T32 NRSA: HS000063"],"award-info":[{"award-number":["AHRQ T32 NRSA: HS000063"]}]},{"name":"NIH K24","award":["HL004184"],"award-info":[{"award-number":["HL004184"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2012,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Readmission within 30 days after hospitalization for sickle cell crisis was developed by The National Association of Children's Hospitals (NACHRI) to improve hospital quality, however, there have been few studies validating this.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>We performed a retrospective examination of 12,104 hospitalizations for sickle crisis from July 1, 2006 and December 31, 2008 at 33 freestanding children's hospitals in the Pediatric Health Information System (PHIS) database. Hospitalizations met NACHRI criteria; inpatient admission, APR DRG code 662, age\u2009&lt;\u200918, discharge home, and length of stay within 2 SD of the mean. We describe 30\u2010day readmission rates, identify factors associated with readmission accounting for patient\u2010level clustering and compare unadjusted versus adjusted variation in readmission rates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We identified 4,762 patients with 12,104 qualifying hospitalizations (1\u201330 per patient). Two thousand seventy\u2010four (17%) hospitalizations resulted in a readmission within 30 days. Significant factors associated with readmission were age (OR 1.06\/year,<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001), inpatient use of steroids (OR 1.48,<jats:italic>P<\/jats:italic>\u2009=\u20090.01) admission for pain without other sickle complications (OR 1.52,<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.0001) and simple transfusion (OR 0.58,<jats:italic>P<\/jats:italic>\u2009=\u20090.0002). There was significant variation in readmission rates between hospitals, even after accounting for clustering by patient and hospital case mix.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In a sample of free\u2010standing children's hospitals, 17% of hospitalizations for sickle cell crisis result in readmission within 30 days. Older patients, those treated with steroids and those admitted for pain are more likely to be readmitted; simple transfusion is protective. Even after adjusting for case mix substantial hospital variation remains, but specific hospital to hospital comparisons differ depending on the exact methods used. Pediatr Blood Cancer 2012; 58: 61\u201365. \u00a9 2011 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.23221","type":"journal-article","created":{"date-parts":[[2011,6,14]],"date-time":"2011-06-14T19:47:39Z","timestamp":1308080859000},"page":"61-65","source":"Crossref","is-referenced-by-count":50,"title":["Thirty\u2010day readmission rates following hospitalization for pediatric sickle cell crisis at freestanding children's hospitals: Risk factors and hospital variation"],"prefix":"10.1002","volume":"58","author":[{"given":"Amy","family":"Sobota","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dionne A.","family":"Graham","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellis J.","family":"Neufeld","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew M.","family":"Heeney","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2011,6,14]]},"reference":[{"key":"e_1_2_6_2_2","volume-title":"Crossing the quality chasm: A new health system for the 21st century","author":"Committee on Quality of Health Care in America","year":"2001"},{"key":"e_1_2_6_3_2","unstructured":"June 30 2008. CMS Targets Readmissions Through Payment Audits: \u2018Coaching\u2019 Model Reduces Rates. In Report on Medicare Compliance. <http:\/\/www.cfmc.org\/files\/rmc063008.pdf>. Accessed Oct 20 2010."},{"key":"e_1_2_6_4_2","unstructured":"Patient Protection and Affordable Care Act. Senate and House of Representatives of the United States of America March 23 2010."},{"key":"e_1_2_6_5_2","unstructured":"QualityNet. Oct 20 2010. Readmission Measures Overview: Publicly reporting risk\u2010standardized 30\u2010day readmission measures for AMI HF and PN. <http:\/\/www.qualitynet.org\/dcs\/ContentServer?c=Page&pagename=QnetPublic%2FPage%2FQnetTier2&cid=1219069855273>. Accessed Oct 20 2010."},{"key":"e_1_2_6_6_2","unstructured":"NQMC 2010 Oct 20 2010. Asthma: Risk\u2010adjusted rate of unplanned readmission following discharge for asthma. <http:\/\/www.qualitymeasures.ahrq.gov\/content.aspx?id=15071&search=readmission>. 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July 2008. List of Non\u2010Core Measures for PQMS; Sickle Cell Anemia Crisis Readmission Rate. <http:\/\/www.childrenshospitals.net\/AM\/Template.cfm?Section=en&CONTENTID=40765&TEMPLATE=\/CM\/HTMLDisplay.cfm>. Accessed Oct 20 2010."},{"key":"e_1_2_6_19_2","unstructured":"McCavitT ZhangS AhnC et al.Quality of Care in Hospitalizations for Sickle Cell Disease in the U.S.: Do Low Patient Volumes Mean Higher Mortality? 50th ASH Annual Meeting and Exposition Online Program and Abstracts San Francisco CA 2008."},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.20180"},{"key":"e_1_2_6_21_2","unstructured":"HughesJ.2009 Oct 20 2010. 3M Health Information Systems (HIS) APR DRG Classification Software\u2014Overview. In Mortality Measurement Agency for Healthcare Research and Quality. <http:\/\/www.ahrq.gov\/qual\/mortality\/hughessumm.htm>. 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