Swansea Centre for Health Economics, Swansea University, Swansea, UK.
Acta Paediatr. 2013 Apr;102(4):e158-63. doi: 10.1111/apa.12124. Epub 2013 Jan 9.
To quantify readmissions with infectious diseases and differences in readmission patterns.
Using the CHKS database, children <5 years admitted to hospital in England and Wales, between 2000 and 2008, with rotavirus (RV), respiratory syncytial virus (RSV) or non-rotaviral gastroenteritis (NRV) were identified. All admissions within a 30-day prior period were similarly identified, and the proportion of readmissions was calculated.
There were 365,693 admissions for RV, RSV and NRV; 17.2% were readmissions. In 36% of cases, the cause of the prior admission was also RV, RSV or NRV, with 64% having a different prior diagnosis. The majority of readmissions were within 5 days of their prior admission, the majority of those with RV (n = 2,566/58.7%) within 3 days, NRV (n = 11 326/53.5%) within 4 days and RSV (n = 18 811/50.2%) within 9 days of prior discharge. Readmission for RV was associated with greater LOS than RSV (p < 0.001) and NRV (p < 0.001), while cost per admission was greater for RV compared to RSV (p < 0.001) and NRV (p < 0.001).
Thirty-six percent of readmissions indicated discharge without resolution from the first admission; nosocomial infection needs to be considered as a cause in the other. Although RSV represented the largest readmission group, higher costs and longer LOS were associated with RV.
量化传染病再入院情况和再入院模式的差异。
利用 CHKS 数据库，筛选 2000 至 2008 年期间英格兰和威尔士 5 岁以下因轮状病毒（RV）、呼吸道合胞病毒（RSV）或非轮状病毒胃肠炎（NRV）住院的患儿。同样确定了在此前 30 天内所有入院的情况，并计算了再入院的比例。
共有 365693 例 RV、RSV 和 NRV 住院患儿，其中 17.2%为再入院。36%的再入院患儿的首要病因也是 RV、RSV 或 NRV，64%的患儿存在不同的先前诊断。大多数再入院发生在出院后 5 天内，RV 再入院患儿（n=2566，占 58.7%）中的大多数在出院后 3 天内，NRV 再入院患儿（n=11326，占 53.5%）中的大多数在出院后 4 天内，RSV 再入院患儿（n=18811，占 50.2%）中的大多数在出院后 9 天内。与 RSV（p<0.001）和 NRV（p<0.001）相比，RV 再入院患儿的住院时间（LOS）更长，而每次入院的费用则高于 RSV（p<0.001）和 NRV（p<0.001）。
36%的再入院患儿表明首次入院时未痊愈出院；在其他患儿中，医院感染需要被考虑为病因。尽管 RSV 是再入院人数最多的群体，但 RV 与更高的成本和更长的 LOS 相关。
