Factors associated with hospital admission and 30-day readmission for children less than 18 years of age in 2018 in France: a one-year nationwide observational study

• Published in: BMC health services research Vol. 23; no. 1; pp. 1 - 901
• Main Authors: Pergeline, Jeanne, Rey, Sylvie, Fresson, Jeanne, Debeugny, Gonzague, Rachas, Antoine, Tuppin, Philippe
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 23-08-2023; BioMed Central; BMC
• Subjects: Admission and discharge; Age; Ambulatory care; Beneficiaries; Children; Conditions; Emergency medical care; Health aspects; Health insurance; Health services; Healthcare services use; Hospital costs; Hospitalization; Hospitals; Households; Insurance coverage; Multiple births; Observational studies; Patient admissions; Primary care; Reimbursement; Short stay hospital; Sociodeprivation; France
• ISSN: 1472-6963; 1472-6963
• DOI: 10.1186/s12913-023-09861-2

Background Nationwide data for children for short-stay hospitalisation (SSH) and associated factors are scarce. This retrospective study of children in France < 18 years of age followed after their birth or birthday in 2018 focused on at least one annual SSH, stay < 1 night or [greater than or equal to] 1 night, or 30-day readmission [greater than or equal to] 1 night. Methods Children were selected from the national health data system (SNDS), which includes data on long-term chronic disease (LTD) status with full reimbursement and complementary universal coverage based on low household income (CMUC). Uni and multivariate quasi-Poisson regression were applied for each outcome. Results Among 13.211 million children (94.4% population, 51.2% boys), CMUC was identified for 17.5% and at least one LTD for 4% (0-<1 year: 1.5%; 14-<18 year: 5.2%). The most frequent LTDs were pervasive developmental diseases (0.53%), asthma (0.24%), epilepsy (0.17%), and type 1 diabetes (0.15%). At least one SSH was found for 8.8%: SSH < 1 night (4.9%), SSH [greater than or equal to] 1 night (4.5%), readmission (0.4%). Children with at least one SSH were younger (median 6 vs. 9 years) and more often had CMUC (21%), a LTD (12%), an emergency department (ED) visit (56%), or various primary healthcare visits than all children. Those with a SSH [greater than or equal to]1 night vs. < 1 night were older (median: 9 vs. 4 years). They had the same frequency of LTD (13.4%) but more often an ED visit (78% vs. 42%). Children with readmissions were younger (median 3 years). They had the highest levels of CMUC (29.3%), LTD (34%), EDs in their municipality (35% vs. 29% for the whole population) and ED visits (87%). In adjusted analysis, each outcome was significantly less frequent among girls than boys and more frequent for children with CMUC. LTDs with the largest association with SSH < 1 night were cystic fibrosis, sickle cell diseases (SCD), diabetes type 1, those with SSH [greater than or equal to]1 night type 1 diabetes epilepsy and SCD, and those for readmissions lymphoid leukaemia, malignant neoplasm of the brain, and SCD. Among all SSH admissions of children < 10 years, 25.8% were potentially preventable. Conclusion Higher SSH and readmission rates were found for children with certain LTD living in low-income households, suggesting the need or increase of specific policy actions and research. Keywords: Children, Short stay hospital, Healthcare services use, Conditions, Sociodeprivation