Westley-Wise Victoria, Lago Luise, Mullan Judy, Facci Franca, Zingel Rebekah, Eagar Kathy
Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia.
Centre for Health Research Illawarra Shoalhaven Population, Australian Health Services Research Institute, University of Wollongong, Wollongong, New South Wales, Australia.
Chronic Illn. 2022 Mar;18(1):86-104. doi: 10.1177/1742395319899459. Epub 2020 Feb 9.
To describe morbidity and multimorbidity patterns among adults readmitted to an Australian regional health service, in terms of occurrence of the same and different morbidities at index admission and readmission.
This cohort study used hospital admissions data for patients admitted between 1 July 2014 and 30 June 2016 to estimate proportions of unplanned readmissions ('early' within 30 days and 'late' within 1-6 months) with the same and different morbidities as the index admission. Readmission rates were estimated by selected sociodemographic, admission and diagnostic characteristics.
The majority of early and late readmissions were in different diagnostic groups and for different primary morbidities to the index admission. Only 38.8% of readmissions were in the same major diagnostic group as the index admission and 18.4% in the same Adjacent Diagnosis-Related Group. Twenty one percent of admitted patients were readmitted within six months, with this increasing to 35.3% among multimorbid patients.
With increasing prevalence of multimorbidity, particularly among those at increased risk of readmission, it is essential to step away from a single disease focus in the design of both hospital avoidance and chronic disease management programmes. Holistic interventions and strategies that address multiple chronic conditions are required.
根据首次入院和再次入院时相同及不同疾病的发生情况，描述澳大利亚某地区医疗服务机构再次入院成人的发病情况和多种疾病共存模式。
这项队列研究使用了2014年7月1日至2016年6月30日期间入院患者的医院数据，以估计与首次入院相同及不同疾病的非计划再次入院（30天内“早期”和1至6个月内“晚期”）比例。通过选定的社会人口统计学、入院和诊断特征来估计再入院率。
大多数早期和晚期再入院患者的诊断组不同，主要疾病也与首次入院不同。只有38.8%的再入院患者与首次入院属于同一主要诊断组，18.4%属于同一相邻诊断相关组。21%的入院患者在六个月内再次入院，在患有多种疾病的患者中这一比例增至35.3%。
随着多种疾病共存情况的日益普遍，尤其是在再入院风险较高的人群中，在设计避免住院和慢性病管理方案时，必须摒弃单一疾病的关注点。需要采取针对多种慢性病的整体干预措施和策略。
