Interuniversity Centre for Health Economics Research, Vrije Universiteit Brussel, Brussels, Belgium.
Strategic Information Department, UZ Brussel, Brussels, Belgium.
Disabil Rehabil. 2020 Jun;42(11):1599-1606. doi: 10.1080/09638288.2018.1531152. Epub 2019 Jan 7.
In recent years, there has been an increasing interest in measuring and modeling health care utilization. However, only limited research has been performed in the field of health care utilization following road traffic accidents. This article aims to measure the incremental health care utilization after hospital discharge after a road traffic accident and explore the association between socio-demographic and injury-related variables and health care utilization. Generalized linear models with negative binomial distribution and log-link were executed per type of health care provider (general practitioner, medical specialists, rehabilitation services and outpatient nursing care) and per type of discharge location (discharged to home, discharged to in-hospital rehabilitation). Health care utilization of the 6 months after discharge was compared with the 6 months before the accident (baseline care). Health care utilization six months after discharge is significantly higher than baseline care, except for outpatient nursing care and general practitioners in in-hospital rehabilitation. The increase in visits to medical specialists ranged on average between 1 and 2.2 visits. For general practitioner, there was an increase of 0.4 visits and 0.8 in outpatient nursing care for those who returned home after acute hospitalization. The average increase in rehabilitation services ranged between 3.6 and 20. Associated influential factors differ per health care provider and discharge destination. Evidence of this study suggests higher health care utilization during the first 6 months following hospitalization due to a road traffic injury, compared with baseline care. Associated variables differ per type of health care provider and discharge-destination. More in-depth research on subgroups is needed.Implications for rehabilitationHealth care utilization varies across different patient characteristics and type of injuries which should be considered in the communication with patients on their care trajectory post-discharge.General descriptions of health care utilization in traffic victims at the population level are lacking. Output similar to our study could serve as a reference for post-discharge care planning.The research output can be a starting point for future research on quality indicators of the expected quantity of care.Efforts must be made to estimate suchlike reference tables on post-discharge services in other patient groups and secondary data are a suitable data-source for those analyses.
近年来，人们对测量和建模医疗保健利用越来越感兴趣。然而，在道路交通伤害后的医疗保健利用领域，仅有有限的研究。本文旨在测量道路交通伤害后出院后的增量医疗保健利用，并探讨社会人口学和伤害相关变量与医疗保健利用之间的关联。使用负二项分布和对数链接的广义线性模型，分别针对每一种医疗保健提供者（全科医生、医学专家、康复服务和门诊护理）和每一种出院地点（出院回家、出院到院内康复）进行分析。将出院后 6 个月的医疗保健利用与事故前 6 个月（基线护理）进行比较。除了门诊护理和院内康复中的全科医生外，出院后 6 个月的医疗保健利用明显高于基线护理。平均而言，就诊医学专家的次数增加了 1 到 2.2 次。对于那些急性住院后出院回家的人，全科医生的就诊次数增加了 0.4 次，门诊护理增加了 0.8 次。康复服务的平均增加量在 3.6 到 20 之间。每个医疗保健提供者和出院目的地的相关影响因素不同。这项研究的证据表明，与基线护理相比，由于道路交通伤害而在住院后前 6 个月内的医疗保健利用率更高。相关变量因医疗保健提供者和出院目的地的类型而异。需要对亚组进行更深入的研究。康复建议不同患者特征和损伤类型的医疗保健利用率不同，在与患者沟通出院后的护理轨迹时应考虑这些因素。缺乏对交通肇事受害者人群水平医疗保健利用的一般描述。与我们的研究类似的结果可以作为出院后护理计划的参考。研究结果可以为预期护理量的质量指标的未来研究提供起点。必须努力估计其他患者群体的出院后服务的类似参考表，并且二次数据是这些分析的合适数据源。
