Risk of rehospitalisation and death for vulnerable New Zealand children
Open accessAbstract
Objectives: There is considerable need to improve the effectiveness of healthcare to reduce morbidity and mortality. Child hospitalisations are influenced by determinants of health, including the home environment. Our aims were: (1) To investigate whether children hospitalised with potentially avoidable conditions thought to be associated with the home have an increased risk of rehospitalisation and death, (2) To investigate whether children hospitalised with particular subgroups of potentially avoidable conditions have an increased risk of rehospitalisation and death, (3) To assess the usefulness of these subgroups for identifying at-risk children. Design: We used four existing groups of potentially avoidable conditions developed based on expert opinion: 1. the potentially avoidable hospitalisations (PAH) group, associated with social/environmental conditions, 2. the potentially avoidable hospitalisations attributable (at least in part) to the home environment (PAHHE) group, 3. the crowding group, and 4. the Ministry of Health (MoH) group. We analysed national New Zealand hospital discharge data (2000–2014). Rehospitalisation and death were described using Kaplan-Meier curves. Group effectiveness for identifying at-risk children was assessed using Cox proportional hazard models with children hospitalised for non-PAH conditions as comparison. Results: In total, 1425085 hospital admissions occurred, for 683115 unique children. Rehospitalisation was relatively common (71.0%). Death was rare (0.6%). All groups performed moderately well identifying at-risk children. Children with PAH have increased risk of rehospitalisation (adjusted HR (aHR):2.30–3.60) and death (aHR:3.07–10.44). PAH group had highest sensitivity (75.1%). The MoH group has the highest positive predictive value (rehospitalisation: 86.2%, death: 2.5%). Conclusions: Children in the MoH group are very likely to benefit from housing interventions. Rehospitalisation and early mortality are useful assessment measures. Rehospitalisation exerts a considerable burden, and child deaths are catastrophic.
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Children who have been admitted to the hospital are more likely to be readmitted.
“children who had been admitted to the hospital were more likely to be readmitted (119).”
From Review of the Impact of Housing Quality on Inequalities in Health and Well-Being (2023) · cites this paper as [119]
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Review of the Impact of Housing Quality on Inequalities in Health and Well-Being
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Self-citation
- Authors
- Oliver, J., Foster, T., Kvalsvig, A., Williamson, D. A., Baker, M. G., & Pierse, N.
- Affiliations
- University of Otago (NZ)
- The University of Melbourne (AU)
- Corresponding author
- Oliver, Jane
- Venue
- Archives of Disease in Childhood
- Publisher
- BMJ
- Published
- 2017-07-22
- Volume
- 103
- Issue
- 4
- Pages
- 327-334
- ISSN
- 0003-9888 (ISSN-L)
- 1468-2044
- OpenAlex
- W2738439937
- Cited by
- 17
- References
- 33
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 3 · 2022: 3 · 2020: 3 · 2019: 5 · 2017: 1
- FWCI
- 3.99
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Disease in Childhood (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Funders
- Health Research Council of New Zealand
- New Zealand Lotteries Health Research
- Topics
- Health Sciences › Health Professions › General Health Professions › Child and Adolescent Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Injury Epidemiology and Prevention
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Keywords
- hospital readmission, child mortality, family environment, housing conditions, crowding, social determinants of health, vulnerable children, housing interventions, New Zealand
- MeSH terms
- Adolescent, Child, Child, Preschool, Female, Hospitalization, Housing, Humans, Infant, Male, New Zealand, Risk Factors, Social Environment, Survival Analysis, Risk Assessment, Child Mortality, Social Determinants of Health
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