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中国天津糖尿病患者医院再入院率及其长期变化:一项横断面研究。

The prevalence and long-term variation of hospital readmission for patients with diabetes in Tianjin, China: A cross-sectional study.

作者信息

Liu Xiaoqian, Guo Yuting, Li Dandan, Cui Zhuang, Liu Yuanyuan, Li Changping, Ma Jun

机构信息

Department of Health Statistics, College of Public Health, Tianjin Medical University, Tianjin, China.

出版信息

Medicine (Baltimore). 2017 Oct;96(42):e7953. doi: 10.1097/MD.0000000000007953.

Abstract

Little is known about hospital readmission for patients with diabetes in China. We aimed to assess the temporal pattern, risk factors, and variations of all-cause readmission among hospitalized patients with diabetes in Tianjin, China, from 2008 to 2013.The Tianjin Basic Medical Insurance Register System database was used to identify discharged patients with diabetes from 2008 to 2013. The influential factors and trends of rehospitalization were analyzed for 30-, 60- and 90-day predicted readmission rates. The Blinder-Oaxaca decomposition was used to explain the readmission variations between 2008 and 2013.The long stay-time at the index hospitalization is a shared risk factor for readmission at 30, 60, and 90 days each year. The 90-day predicted readmission rates were the highest for each year (all P < .001). The adjusted readmission rates generally decreased by year (all P < .001), except for at the 90-day interval, which decreased in 2010 and slightly increased in 2013 (from 7.47% in 2012 to 7.65% in 2013). If the patients had been readmitted to the hospital in 2013 and the only changes that had occurred since 2008 were observable characteristics, then the readmission rates would have decreased by 0.84%, 0.27%, and 0.18% at 30, 60, and 90 days, respectively. The potential policy changes decreased the readmission rates at 1.35%, 2.01%, and 1.04% for the 3 intervals, respectively.Identifying targeted factors for the decrease in readmission rates may help to control readmission, particularly for long-interval patients.

摘要

在中国,关于糖尿病患者再次入院的情况鲜为人知。我们旨在评估2008年至2013年期间中国天津住院糖尿病患者全因再次入院的时间模式、风险因素及差异。利用天津基本医疗保险登记系统数据库识别2008年至2013年期间出院的糖尿病患者。分析了30天、60天和90天预测再次入院率的影响因素及趋势。采用布林德-奥克分解法解释2008年至2013年期间再次入院的差异。每年指数住院时的长时间住院是30天、60天和90天再次入院的共同风险因素。每年90天预测再次入院率最高(所有P<0.001)。调整后的再次入院率总体上逐年下降(所有P<0.001),但90天间隔期除外,该间隔期在2010年下降,2013年略有上升(从2012年的7.47%升至2013年的7.65%)。如果患者在2013年再次入院,且自2008年以来仅观察到可观察特征的变化,那么30天、60天和90天的再次入院率将分别下降0.84%、0.27%和0.18%。潜在的政策变化使三个间隔期的再次入院率分别下降了1.35%、2.01%和1.04%。确定再次入院率下降的目标因素可能有助于控制再次入院,特别是对于长间隔期患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a04/5662355/35aecab31357/medi-96-e7953-g004.jpg

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