Kelly C L, Thomson K, Wagner A P, Waters J P, Thompson A, Jones S, Holland A J, Redley M
Cambridge Intellectual & Developmental Disabilities Research Group, Department of Psychiatry, University of Cambridge, Cambridge, UK.
Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
J Intellect Disabil Res. 2015 Sep;59(9):835-44. doi: 10.1111/jir.12193. Epub 2015 Mar 31.
This study aims to use 30-day readmission rates to investigate the presumption that men and women with learning disabilities (LDs, known internationally as intellectual disabilities) receive poorer quality hospital care than their non-disabled peers.
A 12-month retrospective audit was conducted using Hospital Episode Statistics (HES) at a single acute hospital in the East of England. This identified all in-patient admissions; admissions where the person concerned was recognised as having a LD; and all emergency readmissions within 30 days of discharge. Additionally, the healthcare records of all patients identified as having a LD and readmitted within 30 days as a medical emergency were examined in order to determine whether or not these readmissions were potentially preventable.
Over the study period, a total of 66 870 adults were admitted as in-patients, among whom 7408 were readmitted as medical emergencies within 30 days of discharge: a readmission rate of 11%. Of these 66 870 patients, 256 were identified as having a LD, with 32 of them experiencing at least one emergency readmission within 30 days: a readmission rate of 13%. When examined, the healthcare records pertaining to these 32 patients who had a total of 39 unique 30-day readmissions revealed that 69% (n = 26) of these readmissions were potentially preventable.
Although overall readmission rates were similar for patients with LDs and those from the general population, patients with LDs had a much higher rate of potentially preventable readmissions when compared to a general population estimate from van Walraven et al. This suggests that there is still work to be done to ensure that this patient population receives hospital care that is both safe and of high quality.
本研究旨在通过30天再入院率来调查一种假设，即患有学习障碍（在国际上称为智力障碍）的男性和女性所接受的医院护理质量低于其非残疾同龄人。
在英格兰东部的一家急性医院，利用医院事件统计数据（HES）进行了为期12个月的回顾性审计。这确定了所有住院病例；确定相关人员患有学习障碍的住院病例；以及出院后30天内的所有紧急再入院病例。此外，还检查了所有被确定患有学习障碍且在30天内作为医疗紧急情况再次入院的患者的医疗记录，以确定这些再入院情况是否有可能预防。
在研究期间，共有66870名成年人住院，其中7408人在出院后30天内作为医疗紧急情况再次入院，再入院率为11%。在这66870名患者中，256人被确定患有学习障碍，其中32人在30天内至少经历了一次紧急再入院，再入院率为13%。在检查与这32名患者相关的医疗记录时发现，他们共有39次独立的30天再入院情况，其中69%（n = 26）的再入院情况有可能预防。
虽然患有学习障碍的患者与普通人群的总体再入院率相似，但与van Walraven等人对普通人群的估计相比，患有学习障碍的患者潜在可预防的再入院率要高得多。这表明仍需努力确保这一患者群体获得安全且高质量的医院护理。
