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4
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波兰 30 天内再入院的流行率、原因和易患因素。

Prevalence, Reasons, and Predisposing Factors Associated with 30-day Hospital Readmissions in Poland.

机构信息

Antoni Jurasz University Hospital No. 1, 85-094 Bydgoszcz, Poland.

Department of Public Health, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, 85-830 Bydgoszcz, Poland.

出版信息

Int J Environ Res Public Health. 2019 Jul 2;16(13):2339. doi: 10.3390/ijerph16132339.

DOI:10.3390/ijerph16132339
PMID:31269713
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6651338/
Abstract

There is a growing interest in quality issues associated with hospital care, with readmissions (rehospitalizations) being one of the main areas of interest. Retrospective data from a 914-bed university hospital in Bydgoszcz, Poland, was used to identify 30-day readmissions in 2015. We developed a catalogue of reasons for rehospitalization and differentiated between planned and unplanned readmissions, as well as those related and unrelated to index (initial) hospitalization. Multilevel logistic regression was used to determine factors associated with readmission risk. A total of 12.5% of patients were readmitted within 30 days of being discharged. The highest readmission rates were identified in pediatric, transplantation, and urology patients. The highest share of readmissions was due to the specific nature of a disease and its routine treatment practice. Almost two-thirds of readmission cases were classified as unplanned and related to the index hospitalization. The following characteristics were associated with a higher risk of rehospitalization: female gender, residing >35 km from the hospital, longer than average and very short stays at index admission, higher comorbidity score, and admission to a high-volume hospital sector. Due to the importance of quality issues in health policy, the topic should be further pursued to identify evidence-based practices that would improve hospitals' performance.

摘要

人们对与医院护理相关的质量问题越来越关注,其中再入院(再次住院)是主要关注领域之一。波兰比得哥什的一家拥有 914 张床位的大学附属医院利用回顾性数据,确定了 2015 年的 30 天再入院率。我们制定了再入院原因目录,并对计划性和非计划性再入院进行了区分,以及与指数(初始)住院相关和不相关的再入院。采用多水平逻辑回归来确定与再入院风险相关的因素。共有 12.5%的患者在出院后 30 天内再次入院。儿科、移植和泌尿科患者的再入院率最高。再入院的最高比例是由于疾病的特定性质及其常规治疗实践。近三分之二的再入院病例被归类为非计划性和与指数住院相关的病例。以下特征与更高的再入院风险相关:女性、居住地距离医院超过 35 公里、指数住院时间长于平均水平和非常短、更高的合并症评分以及入住高容量医院科室。由于质量问题在卫生政策中的重要性,应进一步探讨该主题,以确定基于证据的实践,从而提高医院的绩效。