Tseng Yen-Hsueh, Chen Chi-Wen, Huang Hsiu-Li, Chen Chu-Chieh, Lee Ming-Der, Ko Ming-Chung, Li Chung-Yi
Center for Medical Quality Management, Taipei Veterans General Hospital, Taipei, Taiwan.
Pediatr Int. 2010 Oct;52(5):711-7. doi: 10.1111/j.1442-200X.2010.03129.x.
Readmission temporally close to discharge can best reflect the quality of care received in the last hospitalization, and has been considered a valuable indicator for the quality of care received. The aim of the present study was to investigate the incidence of and predictors for readmission within 31 days after discharge among preterm low-birthweight (PLBW) infants (ICD-9-code: 765.0x) in Taiwan.
Based on Taiwan's National Health Insurance claim data, a population-based cohort including a total of 18,421 PLBW infants born and hospitalized in 2000-02, was analyzed. The cumulative incidence rate (CIR) of readmission and the hazard ratio of readmission in relation to potential predictors were calculated.
The total number of participants readmitted within 15 or 31 days after discharge was 1763 and 2484, representing a CIR of 9.6% and 13.5%, respectively. Significant predictors for readmission within 15 or 31 days were essentially similar. Male gender, weight <1000 g, presence of congenital abnormalities, and lung disease were significant risk factors for readmission. Shorter length of hospital stay (<35 days) was associated with a reduced risk of readmission, and there were significant geographic and hospital variations of readmission, with higher rates noted in the most urbanized area and at regional hospitals.
The short-term readmission rate among Taiwanese PLBW infants is higher than in Western countries. Future studies should be conducted to investigate the causes of apparent geographic and hospital variations of readmission rates in order to make more specific interpretations.
出院后短期内再次入院能最好地反映上次住院期间所接受的护理质量，并且一直被视为所接受护理质量的一项重要指标。本研究的目的是调查台湾地区早产低体重（PLBW）婴儿（国际疾病分类第九版编码：765.0x）出院后31天内再次入院的发生率及预测因素。
基于台湾地区国民健康保险理赔数据，对2000年至2002年出生并住院的18421名PLBW婴儿组成的人群队列进行分析。计算再次入院的累积发生率（CIR）以及与潜在预测因素相关的再次入院风险比。
出院后15天或31天内再次入院的参与者总数分别为1763人和2484人，CIR分别为9.6%和13.5%。15天或31天内再次入院的显著预测因素基本相似。男性、体重<1000克、存在先天性异常以及肺部疾病是再次入院的显著危险因素。住院时间较短（<35天）与再次入院风险降低相关，并且再次入院存在显著的地域和医院差异，在城市化程度最高的地区和区域医院发生率较高。
台湾地区PLBW婴儿的短期再次入院率高于西方国家。未来应开展研究以调查再次入院率明显的地域和医院差异的原因，以便做出更具体的解读。
