Department of Surgery, China Medical University Beigang Hospital, Beigang Township, Yunlin County, Taiwan; School of Medicine, China Medical University, Taichung, Taiwan.
Department of Pediatrics, Chung Kang Branch, Cheng-Ching General Hospital, Taichung, Taiwan.
Burns. 2020 Dec;46(8):1813-1819. doi: 10.1016/j.burns.2020.06.017. Epub 2020 Jun 26.
We investigated whether the availability of a tap water supply system is associated with lowering the admission rate 30 days after burn injury.
We analysed data from the Longitudinal Health Insurance Database 2000 from the National Health Research Institutes. It contains a random sample of 1,000,000 subjects out of 22 million beneficiaries of the National Health Insurance of Taiwan from 1996 to 2010. The included patients were diagnosed twice with burn injuries in local medical departments. The odds ratios and 95% confidence intervals were estimated by logistic regression model to evaluate the correlations of baseline characteristics and comorbidities.
A total of 5,996 patients were identified after 1:1 propensity score matching. They had similar basic characteristics. Ultimately, 96 patients in the case cohort (1.10 per 1,000 person-years) and 58 patients in the control cohort (0.66 per 1,000 person-years) were admitted 30 days after a burn injury (adjusted hazard ratio 1.67, 95% confidence interval 1.21-2.32). A lower incidence of admission because of burn injury was found in the control cohort (log-rank test, p = 0.019). The advantageous effect of a well-equipped tap water system on a lower admission rate in burn patients was independent of comorbidities.
The results of this study demonstrated the association between lowering the admission rate at 30 days in burn patients in Taiwan and using a well-equipped tap water system. It also could offer important information to the government for enhancing the availability of tap water system in those areas lack adequate tap water supply which is useful to protect burn patients from following admission.
本研究旨在探讨是否能通过提供自来水系统来降低烧伤后 30 天的再入院率。
我们分析了来自于台湾全民健康保险研究数据库(National Health Research Institutes)2000 年纵向健康保险数据库的数据。该数据库是从 1996 年至 2010 年 2200 万受保人随机抽取的 100 万受检者组成,其中包括在当地医疗机构两次确诊为烧伤的患者。采用逻辑回归模型评估患者基本特征和合并症与再入院率之间的相关性,计算比值比(odds ratio,OR)及其 95%置信区间(95% confidence interval,CI)。
1:1 倾向评分匹配后共纳入 5996 名患者,两组患者基本特征相似。最终,病例组中有 96 例(每 1000 人年 1.10 例)和对照组中有 58 例(每 1000 人年 0.66 例)在烧伤后 30 天再入院(调整后的 HR 为 1.67,95%CI 为 1.21~2.32)。烧伤后 30 天再入院率在对照组中较低(log-rank 检验,p = 0.019)。具备良好供水设施的自来水系统能降低烧伤患者的再入院率,且该优势独立于合并症。
本研究结果表明,在台湾,具备良好供水设施的自来水系统与烧伤患者 30 天内再入院率降低有关。这为政府提供了重要信息,以便在那些自来水资源不足的地区加强自来水系统的建设,从而保护烧伤患者免受再次入院。