An Examination of Social Determinants of Health and their Association with Preventable and Urgent Readmissions in Pediatric Acute Care Cardiology

Hospital readmissions are costly, often preventable, and associated with both medical and socioeconomic factors. The primary objective of this study was to evaluate the relationship between social determinants of health (SDOH) and readmission to a pediatric acute care cardiology unit. Secondary objectives included assessing the incidence of preventable or urgent readmissions and suggesting interventions to address common causes of these readmissions. This single-center, retrospective analysis reviewed readmissions to the acute care cardiology unit at Cincinnati Children's Hospital within 7 days of discharge from 2019 to 2022. A preventability score and urgency metrics were assigned to each readmission, and multivariable logistic regression was used to obtain odds ratios and 95% confidence intervals according to individual and community-level measures of SDOH. Out of 265 readmission encounters, 27 (10%) were preventable and 74 (28%) were urgent. Readmission length of stay was significantly longer for preventable or urgent readmissions. Birth weight, gestational age, English-speaking status, race/ethnicity, sex, insurance category, deprivation index, and single ventricle status were not significantly associated with preventable or urgent readmissions. The most common reason identified for preventable readmission was insufficient discharge education, and the most common reason identified for urgent readmission was advancement of chronic disease. Measured SDOH were not associated with preventable or urgent readmissions, which may be partially due to our institution's multidisciplinary approach to address SDOH. However, as insufficient discharge education was a common reason for preventable readmission, clearly more work is needed to delineate what specific strategies are most effective for mitigating adverse SDOH.