Henke Rachel Mosher, Karaca Zeynal, Jackson Paige, Marder William D, Wong Herbert S
1 Truven Health Analytics, an IBM Company, Cambridge, MA, USA.
2 Agency for Healthcare Research and Quality, Rockville, MD, USA.
Med Care Res Rev. 2017 Jun;74(3):345-368. doi: 10.1177/1077558716647652. Epub 2016 May 4.
This study examines the association between the quality of hospital discharge planning and all-cause 30-day readmissions and same-hospital readmissions. The sample included adults aged 18 years and older hospitalized in 16 states in 2010 or 2011 for acute myocardial infarction, heart failure, pneumonia, or total hip or joint arthroplasty. Data from the Hospital Consumer Assessment of Healthcare Providers and Systems measured discharge-planning quality at the hospital level. A generalized linear mixed model was used to estimate the contribution of patient and hospital characteristics to 30-day all-cause and same-hospital readmissions. Discharge-planning quality was associated with (a) lower rates of 30-day hospital readmissions and (b) higher rates of same-hospital readmissions for heart failure, pneumonia, and total hip or joint replacement. These results suggest that by improving inpatient discharge planning, hospitals may be able to influence their 30-day readmissions and increase the likelihood that readmissions will be to the same hospital.
本研究探讨了医院出院计划质量与全因30天再入院率以及同院再入院率之间的关联。样本包括2010年或2011年在16个州因急性心肌梗死、心力衰竭、肺炎或全髋关节或关节置换术住院的18岁及以上成年人。来自医疗服务提供者和系统的医院消费者评估数据衡量了医院层面的出院计划质量。使用广义线性混合模型来估计患者和医院特征对30天全因再入院率和同院再入院率的影响。出院计划质量与以下方面相关：(a) 30天医院再入院率较低；(b) 心力衰竭、肺炎和全髋关节或关节置换术的同院再入院率较高。这些结果表明，通过改善住院患者的出院计划，医院或许能够影响其30天再入院率，并增加再入院到同一家医院的可能性。
