Ye Yun, Beachy Micah W, Luo Jiangtao, Winterboer Tammy, Fleharty Brandon S, Brewer Charlotte, Qin Zijian, Naveed Zaeema, Ash Michael A, Baccaglini Lorena
The Ohio State University, Columbus, OH.
University of Nebraska Medical Center, Omaha, NE.
Am J Med Qual. 2019 Nov/Dec;34(6):607-614. doi: 10.1177/1062860619833306. Epub 2019 Mar 5.
Unnecessary hospital readmissions increase patient burden, decrease health care quality and efficiency, and raise overall costs. This retrospective cohort study sought to identify high-risk patients who may serve as targets for interventions aiming at reducing hospital readmissions. The authors compared geospatial, social demographic, and clinical characteristics of patients with or without a 90-day readmission. Electronic health records of 42 330 adult patients admitted to 2 Midwestern hospitals during 2013 to 2016 were used, and logistic regression was performed to determine risk factors for readmission. The 90-day readmission percentage was 14.9%. Two main groups of patients with significantly higher odds of a 90-day readmission included those with severe conditions, particularly those with a short length of stay at incident admission, and patients with Medicare but younger than age 65. These findings expand knowledge of potential risk factors related to readmissions. Future interventions to reduce hospital readmissions may focus on the aforementioned high-risk patient groups.
不必要的医院再入院会增加患者负担,降低医疗质量和效率,并提高总体成本。这项回顾性队列研究旨在识别可能成为旨在减少医院再入院干预目标的高危患者。作者比较了有或没有90天再入院患者的地理空间、社会人口统计学和临床特征。使用了2013年至2016年期间入住2家中西部医院的42330名成年患者的电子健康记录,并进行了逻辑回归分析以确定再入院的危险因素。90天再入院率为14.9%。90天再入院几率显著更高的两类主要患者包括病情严重的患者,特别是那些在首次入院时住院时间较短的患者,以及年龄小于65岁的医疗保险患者。这些发现扩展了与再入院相关的潜在危险因素的知识。未来减少医院再入院的干预措施可能会聚焦于上述高危患者群体。