Readmission characteristics of elective pediatric circumcisions using large-scale administrative data

Joshua D. Roth, Alison C. Keenan, Aaron Carroll, Richard C. Rink, Mark P. Cain, Benjamin Whittam, William E. Bennett

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Introduction and background Elective circumcision is a common procedure, known to be safe and associated with minimal morbidity. There are few data reporting the rates of readmission and reoperation following elective circumcision. Objective We sought to define the rates of readmission and reoperation in the first 7 days following circumcision to accurately counsel families about the risks of this elective procedure. Study design The Pediatric Health Information System (PHIS) was interrogated from 2004 to 2013 for all ambulatory, elective circumcisions (ICD-9 CM code of 640). We assessed readmission with respect to age, insurance status, race, readmission diagnosis, time to readmission, and seasonal differences (due to higher rates of all-cause hospital admissions). We performed logistical regression analysis with a dependent variable of readmission within 7 days and independent variables of age, race, month of admission, and insurance status. Results We identified 95,046 circumcisions from 2004 to 2013 performed in ambulatory surgery centers. Of those, 2906 (3.1%) of patients had an additional encounter at the same facility within 7 days. A total of 2409 (2.4%) of encounters were ER visits, and 253 (0.3%) were encounters for hospital admission or observation. One hundred and thirty-two patients (0.1%) underwent a second ambulatory procedure within the first 7 days following circumcision. Black patients (OR 1.26, p <0.001) and patients on Medicaid (OR 1.63, p <0.001) were more likely to seek care of any kind at the same institution within 7 days of the original circumcision operation. No difference was found with regard to time of year on logistic regression. Older age at circumcision was associated with increased likelihood of reoperation compared to children

Original languageEnglish (US)
Pages (from-to)27.e1-27.e6
JournalJournal of Pediatric Urology
Volume12
Issue number1
DOIs
StatePublished - Feb 1 2016

Fingerprint

Reoperation
Pediatrics
Insurance Coverage
Health Information Systems
Medicaid
International Classification of Diseases
Ambulatory Surgical Procedures
Research Design
Logistic Models
Regression Analysis
Observation
Morbidity

Keywords

  • Complications
  • Post-neonatal circumcision
  • Readmission
  • Reoperation

ASJC Scopus subject areas

  • Urology
  • Pediatrics, Perinatology, and Child Health

Cite this

Readmission characteristics of elective pediatric circumcisions using large-scale administrative data. / Roth, Joshua D.; Keenan, Alison C.; Carroll, Aaron; Rink, Richard C.; Cain, Mark P.; Whittam, Benjamin; Bennett, William E.

In: Journal of Pediatric Urology, Vol. 12, No. 1, 01.02.2016, p. 27.e1-27.e6.

Research output: Contribution to journalArticle

Roth, Joshua D. ; Keenan, Alison C. ; Carroll, Aaron ; Rink, Richard C. ; Cain, Mark P. ; Whittam, Benjamin ; Bennett, William E. / Readmission characteristics of elective pediatric circumcisions using large-scale administrative data. In: Journal of Pediatric Urology. 2016 ; Vol. 12, No. 1. pp. 27.e1-27.e6.
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abstract = "Introduction and background Elective circumcision is a common procedure, known to be safe and associated with minimal morbidity. There are few data reporting the rates of readmission and reoperation following elective circumcision. Objective We sought to define the rates of readmission and reoperation in the first 7 days following circumcision to accurately counsel families about the risks of this elective procedure. Study design The Pediatric Health Information System (PHIS) was interrogated from 2004 to 2013 for all ambulatory, elective circumcisions (ICD-9 CM code of 640). We assessed readmission with respect to age, insurance status, race, readmission diagnosis, time to readmission, and seasonal differences (due to higher rates of all-cause hospital admissions). We performed logistical regression analysis with a dependent variable of readmission within 7 days and independent variables of age, race, month of admission, and insurance status. Results We identified 95,046 circumcisions from 2004 to 2013 performed in ambulatory surgery centers. Of those, 2906 (3.1{\%}) of patients had an additional encounter at the same facility within 7 days. A total of 2409 (2.4{\%}) of encounters were ER visits, and 253 (0.3{\%}) were encounters for hospital admission or observation. One hundred and thirty-two patients (0.1{\%}) underwent a second ambulatory procedure within the first 7 days following circumcision. Black patients (OR 1.26, p <0.001) and patients on Medicaid (OR 1.63, p <0.001) were more likely to seek care of any kind at the same institution within 7 days of the original circumcision operation. No difference was found with regard to time of year on logistic regression. Older age at circumcision was associated with increased likelihood of reoperation compared to children",
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N2 - Introduction and background Elective circumcision is a common procedure, known to be safe and associated with minimal morbidity. There are few data reporting the rates of readmission and reoperation following elective circumcision. Objective We sought to define the rates of readmission and reoperation in the first 7 days following circumcision to accurately counsel families about the risks of this elective procedure. Study design The Pediatric Health Information System (PHIS) was interrogated from 2004 to 2013 for all ambulatory, elective circumcisions (ICD-9 CM code of 640). We assessed readmission with respect to age, insurance status, race, readmission diagnosis, time to readmission, and seasonal differences (due to higher rates of all-cause hospital admissions). We performed logistical regression analysis with a dependent variable of readmission within 7 days and independent variables of age, race, month of admission, and insurance status. Results We identified 95,046 circumcisions from 2004 to 2013 performed in ambulatory surgery centers. Of those, 2906 (3.1%) of patients had an additional encounter at the same facility within 7 days. A total of 2409 (2.4%) of encounters were ER visits, and 253 (0.3%) were encounters for hospital admission or observation. One hundred and thirty-two patients (0.1%) underwent a second ambulatory procedure within the first 7 days following circumcision. Black patients (OR 1.26, p <0.001) and patients on Medicaid (OR 1.63, p <0.001) were more likely to seek care of any kind at the same institution within 7 days of the original circumcision operation. No difference was found with regard to time of year on logistic regression. Older age at circumcision was associated with increased likelihood of reoperation compared to children

AB - Introduction and background Elective circumcision is a common procedure, known to be safe and associated with minimal morbidity. There are few data reporting the rates of readmission and reoperation following elective circumcision. Objective We sought to define the rates of readmission and reoperation in the first 7 days following circumcision to accurately counsel families about the risks of this elective procedure. Study design The Pediatric Health Information System (PHIS) was interrogated from 2004 to 2013 for all ambulatory, elective circumcisions (ICD-9 CM code of 640). We assessed readmission with respect to age, insurance status, race, readmission diagnosis, time to readmission, and seasonal differences (due to higher rates of all-cause hospital admissions). We performed logistical regression analysis with a dependent variable of readmission within 7 days and independent variables of age, race, month of admission, and insurance status. Results We identified 95,046 circumcisions from 2004 to 2013 performed in ambulatory surgery centers. Of those, 2906 (3.1%) of patients had an additional encounter at the same facility within 7 days. A total of 2409 (2.4%) of encounters were ER visits, and 253 (0.3%) were encounters for hospital admission or observation. One hundred and thirty-two patients (0.1%) underwent a second ambulatory procedure within the first 7 days following circumcision. Black patients (OR 1.26, p <0.001) and patients on Medicaid (OR 1.63, p <0.001) were more likely to seek care of any kind at the same institution within 7 days of the original circumcision operation. No difference was found with regard to time of year on logistic regression. Older age at circumcision was associated with increased likelihood of reoperation compared to children

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KW - Reoperation

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