Enhancing NSQIP-Pediatric through integration with the Pediatric Health Information System

Purpose: We implemented and validated a linkage algorithm for cases in both the National Surgical Quality Improvement Program-Pediatric (NSQIP-Peds) and the Pediatric Health Information System (PHIS) to investigate healthcare utilization during the first post-operative year. Methods: NSQIP-Peds and PHIS cases from our institution who were operated on between January 2010 and September 2011 were matched on gender and dates of birth, admission, and discharge. Rates of true matches were validated using medical records. We examined rates of emergency department (ED) visits, hospital readmissions, potentially preventable readmissions (PPR), and hospital charges within one year of the NSQIP-Peds encounter. Results: Of the 2,409 NSQIP-Peds and 61,147 PHIS records, 93.6% met match criteria with 92.5% being true matches. Post-operative ED visit rates were 7.8% within 30 days, 17.2% between 31-180 days, and 18.1% between 181-365 days. Readmission rates were 5.5% within 30 days, 9.3% between 31-180 days, and 8.4% between 181-365 days. In patients undergoing inpatient procedures, 10.6% had readmissions within 30 days, and 23.7% had readmissions within 365 days that were potentially preventable. Conclusions: Using indirect identifiers, a linked NSQIP-Peds-PHIS dataset demonstrated high rates of ED visits, readmissions, and PPR in the first post-operative year. This dataset may provide a more comprehensive way to study health care utilization and clinical outcomes. (C) 2014 Elsevier Inc. All rights reserved.