Discussion
This study adds information about the cumulative incidence and characteristics of urgent and elective readmissions of children in a general hospital and gives insight into the kind of readmissions, their patterns and potential preventability. In a cohort of 16,066 children the incidence of both urgent and elective readmissions was 5.9 %. Urgent readmissions made up for 4.9% of all admissions. Compared to reported overall readmission rates in other studies(6,7,8,12-14) of 6.5-13.3% our readmission rate was low, although the generalizability is limited, because these studies were conducted in other countries and primarily in children’s clinics with different patient populations. In general it is difficult to compare readmission
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The most obvious limitation is the retrospective design, relying solely on administrative data and especially relying on DBC for the corresponding diagnosis. The DBC mainly consists of one code, no distinction can be made between primary and secondary diagnosis. In ICD-10 codes primary and secondary conditions can be obtained, but these codes were not available for our study. Furthermore, the DBC of newborns do not have a specific diagnosis DBC but a care code DBC. Newborns are only classified by gestational age and birth(vaginal or cesarean section). Therefore we lack insight and information of the primary diagnosis of the initial admission and the proportion of readmissions with a different DBC is also influenced. Another shortcoming is that we did not include readmissions that occurred in a different hospital and vice versa (admissions that were in fact readmissions from another hospital). Khan et al(26) described in their study that in same-hospital readmissions the readmission rate is underestimated, different-hospital readmissions constituted of 13.9% of all-hospital pediatric readmissions. This study contributes to the understanding of readmissions in our hospital. Further prospective research will be conducted to determine the underlying causes of