Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, UK
Department of Public Health and Policy, University of Liverpool, Liverpool, UK.
Heart. 2020 Mar;106(5):374-379. doi: 10.1136/heartjnl-2019-315047. Epub 2019 Aug 22.
To examine the effects on emergency hospital admissions, length of stay and emergency re-admissions of providing a consultant-led, community-based cardiovascular diagnostic, treatment and rehabilitation service, based in a highly deprived area in the North West of England.
A longitudinal matched controlled study using difference-in-differences analysis compared the change in outcomes in the intervention population, to the change in outcomes in a matched comparison population that had not received the intervention, 5 years before and after implementation. The outcomes were emergency hospitalisations, length of inpatient stay and re-admission rates for cardiovascular disease (CVD).
Findings show that the intervention was associated with 66 fewer emergency CVD admissions per 100 000 population per year (95% CI 22.13 to 108.98) in the post-intervention period, relative to the control group. No significant measurable effects on length of stay or emergency re-admission rates were observed.
This consultant-led, community-based cardiovascular diagnostic, treatment and rehabilitation service was associated with a lower rate of emergency hospital admissions in a highly disadvantaged population. Similar approaches could be an effective component of strategies to reduce unplanned hospital admissions.
考察在英格兰西北部一个高度贫困地区,提供以顾问为主导、以社区为基础的心血管诊断、治疗和康复服务对急诊住院、住院时间和急诊再入院的影响。
采用差分法分析对纵向匹配对照研究进行分析,比较干预人群和未接受干预的匹配对照组在实施前 5 年和实施后 5 年的结果变化。结果为心血管疾病(CVD)的急诊住院、住院时间和再入院率。
研究结果表明,与对照组相比,干预后每年每 10 万人中有 66 例因心血管疾病急诊入院的人数减少(95%CI 22.13 至 108.98)。没有观察到对住院时间或急诊再入院率的显著影响。
在高度弱势群体中,以顾问为主导、以社区为基础的心血管诊断、治疗和康复服务与较低的急诊住院率相关。类似的方法可能是减少非计划性住院的有效策略的组成部分。