Why the study?
It was unclear whether ICD social risk code documentation is prevalent or associated with pediatric health care use outcomes, including length of stay and readmission.
Does documentation of ICD social risk codes predict long length of stay and readmission in hospitalized children?
Does documentation of ICD social risk codes predict long length of stay and readmission in hospitalized children?
Documentation of social risk factors via ICD codes in pediatric hospitalizations is associated with prolonged length of stay, highlighting the impact of social determinants on healthcare utilization.
Social determinants may prolong pediatric hospitalizations; leaves open whether ICD social codes aid readmission prediction or risk stratification.
BACKGROUND AND OBJECTIVES: (ICD) or whether documentation is associated with health care use outcomes. Using a large administrative database of pediatric hospitalizations, we examined the prevalence of ICD social risk code documentation and hypothesized that social code documentation would be associated with longer length of stay (LOS) and readmission. METHODS: We analyzed hospitalizations of children ages ≤18 using the 2012 Nationwide Readmissions Database. The following ICD social codes were used as predictors: family member with alcohol and/or drug problem, history of abuse, parental separation, foster care, educational circumstance, housing instability, other economic strain, and legal circumstance. Outcomes included long LOS (top quintile) and readmission within 30 days after discharge. Covariates included individual, hospital, and season variables. RESULTS: social codes. Social code documentation was significantly associated with long LOS. Adjusting for covariates, family alcohol and/or drug problem (odds ratio [OR] 1.65; 95% confidence interval [CI] 1.16-2.35), foster care (OR 2.37, 95% CI 1.53-3.65), other economic strain (OR 2.12, 95% CI 1.38-3.26), and legal circumstances (OR 1.66; 95% CI 1.02-2.71) remained significant predictors of long LOS. Social code documentation was not associated with readmission after adjusting for covariates. CONCLUSIONS: Social ICD codes are associated with prolonged LOS and readmission in pediatric hospitalizations, but they are infrequently documented. Future work exploring these associations could help to determine if addressing social risk factors in inpatient settings might improve child health outcomes.
No takes yet. Share an insight, caveat, or question.
Pantell et al. (2020) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: