Does the Presence of Paediatric Respiratory Virtual Wards Impact the Risk of Hospital Readmission for Asthma in Children and Young People (CYP)? (ID 654)
University of Leicester
Abstract
Background: Virtual wards enable remote monitoring of patients with respiratory symptoms through digital technology. We assessed whether children and young people (CYP) admitted to hospitals with paediatric virtual wards had lower readmissions compared with CYP at hospitals without virtual wards.
Methods: Data from the 2022-23 CYP asthma secondary care National Respiratory Audit Programme (NRAP) were used NRAP is a continuous national audit in respiratory care across England and Wales. Submitted hospital level data on emergency admissions are linked to Hospital Episode Statistics (HES), Patient Episode Dataset for Wales, and Office of National Statistics mortality data. Patients were included if they: were admitted with acute asthma to a paediatric ward in participating hospitals in England; could be linked with HES; and were alive at discharge. Mixed -effects logistic regression models accounting for clustering by hospital assessed the association between presence of a virtual ward and number of virtual ward beds and 30- and 90-day all-cause and asthma readmissions.
Results: 19/116 hospitals had a paediatric virtual ward. Characteristics of patients admitted to hospitals with and without a virtual ward are presented in the Table. The adjusted odds ratio (OR) for 30-day and 90-day asthma readmissions in hospitals with virtual wards compared with those without were 1.00 (95% CI: 0.69–1.44, p=0.99) and 1.03 (95% CI: 0.77–1.38, p=0.84), respectively. For all-cause readmissions, the OR for 30-day and 90-day readmission was 0.97 (95% CI: 0.72–1.31, p=0.81) and 1.12 (95% CI: 0.90–1.40, p=0.32). 30-day and 90-day asthma readmission adjusted ORs for an increase of 1 virtual ward bed per CYP asthma admission were 0.50 (95% CI: 0.03 – 9.36, p=0.65) and 0.64 (95% CI: 0.07 – 5.87, p=0.69), respectively. All-cause 30-day and 90-day readmission ORs in hospitals with a greater number of virtual beds were 0.68 (95% CI: 0.07 – 6.95, p=0.75) and 2.46 (95% CI: 0.47 – 12.92, p=0.29), respectively.
Conclusion: No reduction in readmission in hospitals with access to virtual wards was noted. This study was limited by low readmission rates and lack of detailed patient-level data on admission. Further studies are required.
Funding: National Respiratory Audit Program, Royal College of Physicians - Healthcare Improvement Quality Partnership
Conflicts of interest: Aleksandra Gawlik-Lipinski: Paid honoraria from Chiesi and AstraZeneca
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