Sluggett Janet K, Caughey Gillian E, Ward Michael B, Roughead Elizabeth E, Gilbert Andrew L
Quality Use of Medicines and Pharmacy Research Centre, Sansom Institute for Health Research, University of South Australia, GPO Box 2471, Adelaide, SA 5001, Australia.
BMC Res Notes. 2013 Apr 2;6:128. doi: 10.1186/1756-0500-6-128.
Stroke patients may have multiple hospital separations relating to the same stroke. Understanding the pattern of hospitalisations for these patients enables first and recurrent events to be distinguished to better understand care. The aim of this study was to investigate reasons for hospital separations after transient ischaemic attack (TIA) or ischaemic stroke and construct episode of care criteria.
A retrospective observational study was conducted using the Australian Government Department of Veterans' Affairs administrative claims database. All patients hospitalised for TIA or ischaemic stroke in 2008-2009 were included. Reasons for hospital separations in the 60 days after TIA or ischaemic stroke were classified by a clinical panel as 'probably', 'possibly' or 'unlikely' to be related to the index separation. Based on panel assessment and time between separations, episode of care criteria for TIA and ischaemic stroke were constructed.
Of the 4520 veterans alive after the index separation, 32% of TIA patients (n=782) and 63% of ischaemic stroke patients (n=1323) had another separation within 60 days. The clinical panel reviewed 460 unique reasons for readmission. Of the 3263 separations, 55% and 85% were classified as related to the index TIA and ischaemic stroke separation, respectively.
Patients hospitalised for ischaemic stroke are likely to have multiple hospital separations for treatment of the same event. Multiple separations for treatment of TIA were less frequent. Consideration of these related separations is recommended when assessing health service utilisation from claims databases.
中风患者可能因同一次中风而多次住院。了解这些患者的住院模式有助于区分首次发作和复发事件，从而更好地理解治疗情况。本研究的目的是调查短暂性脑缺血发作（TIA）或缺血性中风后住院分离的原因，并构建护理事件标准。
使用澳大利亚政府退伍军人事务部行政索赔数据库进行了一项回顾性观察研究。纳入了2008 - 2009年因TIA或缺血性中风住院的所有患者。TIA或缺血性中风后60天内住院分离的原因由一个临床小组分类为“可能”、“有可能”或“不太可能”与首次分离相关。基于小组评估和分离之间的时间，构建了TIA和缺血性中风的护理事件标准。
在首次分离后仍存活的4520名退伍军人中，32%的TIA患者（n = 782）和63%的缺血性中风患者（n = 1323）在60天内再次分离。临床小组审查了460个再次入院的独特原因。在3263次分离中，分别有55%和85%被分类为与首次TIA和缺血性中风分离相关。
因缺血性中风住院的患者可能因同一事件的治疗而多次住院。TIA治疗的多次分离较少见。在从索赔数据库评估卫生服务利用情况时，建议考虑这些相关分离。
