Understanding predictors of postdischarge deaths: a prospective evaluation of children 5 years and younger discharged from Philippine district hospitals.

Background: Factors that increase likelihood of readmission or mortality postdischarge from diarrhea and pneumonia cases among children is less understood.

Methods: This study investigated the deaths of 24 children from a cohort of 3275. Using logistic regression, the authors compared data from those who survived with those who died to estimate the determinants of mortality in the study population. The authors also analyzed the hospital charts and completed mortality interviews with families of the deceased children.

Results: Poor quality of care significantly increased the likelihood of mortality. Sicker children, those born to less-educated mothers, and those who had longer lengths of stay also had a higher likelihood of mortality. Hospital charts corroborated findings from clinical vignettes. The mortality interviews revealed delays in seeking care from onset of symptoms.

Conclusion: Quality of care contributes to postdischarge mortality and that clinical vignettes are an effective means to identify where quality can be improved.