Re-admission rate and its associated factors in a county hospital in Kenya

Abstract

Objective: To assess the re-admission rate and its associated factors in the paediatric ward at Thika level five hospital.

Design: A descriptive cross-sectional study.

Setting: Secondary level hospital in sub-Saharan Africa.

Subjects: A total of 803 children aged 13 years and below admitted between March and June 2019.

Outcome measures: Re-admission of a patient within 30 days of the index admission.

Results: The study found a re-admission of rate 10.2%. Among the readmitted patients 26.83% had a comorbidity and 29.26% had been given incorrect drug dosages during their first admission. A greater proportion (63.4%) of the readmitted patients had the same diagnosis with the index admission with pneumonia, gastroenteritis and meningitis ranking top in the list. A larger percentage of the readmitted children were discharged (83.5%), 8.9% were referred and 7.6% died. Multivariate analysis identified strong associations of hospital re-admission with the length of hospital stay during the index admission, the qualification of the health practitioner who initially discharged the patient and whether the correct drug dosages were administered during the index hospital stay.

Conclusion: About a tenth of discharged children were readmitted within 30 days of discharge. Pneumonia was the commonest condition at admission and re-admission. The hospital factors associated with re-admission included length of hospital stay, level of training of the health care worker who discharged the patient as well as having received incorrect drug dosage during the first admission. There were no significant patient factors.