• 文献检索
  • 文档翻译
  • 深度研究
  • 学术资讯
  • Suppr Zotero 插件Zotero 插件
  • 邀请有礼
  • 套餐&价格
  • 历史记录
应用&插件
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
定价
高级版会员购买积分包购买API积分包
服务
文献检索文档翻译深度研究API 文档MCP 服务
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2026

文献检索

告别复杂PubMed语法,用中文像聊天一样搜索,搜遍4000万医学文献。AI智能推荐,让科研检索更轻松。

立即免费搜索

文件翻译

保留排版,准确专业,支持PDF/Word/PPT等文件格式,支持 12+语言互译。

免费翻译文档

深度研究

AI帮你快速写综述,25分钟生成高质量综述,智能提取关键信息,辅助科研写作。

立即免费体验

教学服务与非教学服务的再入院情况:它们有何不同?

Readmissions on Teaching Versus Non-Teaching Services: Are They Any Different?

作者信息

Shaw Jawaid A, Ali Asghar, Qaiser Rabia, Layman Erynn, Fagan Cynthia, Schwartz Owen, Sima Adam, Hazelrigg Monica

机构信息

Internal Medicine, Virginia Commonwealth University, Richmond, USA.

Internal Medicine/Hospital Medicine, Hunter Holmes McGuire VA Medical Center/Virginia Commonwealth University, Richmond, USA.

出版信息

Cureus. 2020 Jun 9;12(6):e8529. doi: 10.7759/cureus.8529.

DOI:10.7759/cureus.8529
PMID:32665876
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7352802/
Abstract

Introduction There is a paucity of comparative data on readmissions between teaching services (TS) and nonteaching services (NTS). Therefore, we designed this study to determine if there are any differences in readmissions between the two services. Materials and methods A unique cohort of 384 readmissions during one year was retrospectively examined at Hunter Holmes McGuire Veterans Medical Center. The data on patient demographics, baseline characteristics, comorbid illnesses, length of stay (LOS), and reasons for readmission within 30 days were extracted. Results There were no differences in readmission rates (8.2% vs. 10.2%; P = .135), LOS during index admission (4.2 ± 4.8 vs. 4.1 ± 3.5; P = .712), and age-adjusted Charlson Comorbid Index Score (6.1 ± 3.0 vs. 6.8 ± 2.8; P = .037) between the TS and NTS groups. However, the reasons for readmissions between the two groups were statistically significantly different (P < .01). Specifically, these differences were found between system issues and new diagnoses. The NTS showed higher rates of readmissions secondary to new diagnoses and systems issues, whereas the TS showed higher rates of secondary to clinician issues and disease progression. Conclusions We have a new understanding of the difference in reasons for readmissions between TS and NTS; it possibly results from the different structures of the two teams, which may help us address readmissions in a different light to improve overall readmission rate.

摘要

引言

关于教学服务(TS)和非教学服务(NTS)再入院情况的比较数据较少。因此,我们设计了本研究以确定这两种服务在再入院方面是否存在差异。

材料与方法

在亨特·霍姆斯·麦圭尔退伍军人医疗中心对一组独特的384例一年内的再入院病例进行了回顾性研究。提取了患者人口统计学、基线特征、合并疾病、住院时间(LOS)以及30天内再入院原因的数据。

结果

TS组和NTS组在再入院率(8.2%对10.2%;P = 0.135)、首次入院期间的住院时间(4.2±4.8对4.1±3.5;P = 0.712)以及年龄调整后的查尔森合并症指数评分(6.1±3.0对6.8±2.8;P = 0.037)方面没有差异。然而,两组之间的再入院原因在统计学上有显著差异(P < 0.01)。具体而言,这些差异存在于系统问题和新诊断之间。NTS组因新诊断和系统问题导致的再入院率较高,而TS组因临床医生问题和疾病进展导致的再入院率较高。

结论

我们对TS和NTS再入院原因的差异有了新的认识;这可能是由于两个团队的结构不同,这可能有助于我们从不同角度解决再入院问题,以提高总体再入院率。

相似文献

1
Readmissions on Teaching Versus Non-Teaching Services: Are They Any Different?教学服务与非教学服务的再入院情况:它们有何不同?
Cureus. 2020 Jun 9;12(6):e8529. doi: 10.7759/cureus.8529.
2
A comparison of congestive heart failure readmissions among teaching and nonteaching hospital services.教学医院与非教学医院服务中充血性心力衰竭再入院情况的比较。
South Med J. 2014 Aug;107(8):501-7. doi: 10.14423/SMJ.0000000000000152.
3
Influence of frailty-related diagnoses, high-risk prescribing in elderly adults, and primary care use on readmissions in fewer than 30 days for veterans aged 65 and older.65 岁及以上老年退伍军人在 30 天内再次入院的影响因素:与虚弱相关的诊断、老年高危人群处方、初级保健使用。
J Am Geriatr Soc. 2014 Feb;62(2):291-8. doi: 10.1111/jgs.12656. Epub 2014 Jan 21.
4
A comparative study of unscheduled hospital readmissions in a resident-staffed teaching service and a hospitalist-based service.一项针对驻院医师教学服务模式与基于医院医师服务模式下非计划内医院再入院情况的对比研究。
South Med J. 2009 Feb;102(2):145-9. doi: 10.1097/SMJ.0b013e31818bc48a.
5
Factors associated with unplanned readmissions in a major Australian health service.澳大利亚一家大型医疗服务机构中与非计划再入院相关的因素。
Aust Health Rev. 2019 Feb;43(1):1-9. doi: 10.1071/AH16287.
6
Which Clinical and Patient Factors Influence the National Economic Burden of Hospital Readmissions After Total Joint Arthroplasty?哪些临床和患者因素会影响全关节置换术后再入院的国家经济负担?
Clin Orthop Relat Res. 2017 Dec;475(12):2926-2937. doi: 10.1007/s11999-017-5244-6.
7
Comparison of resource utilization and clinical outcomes between teaching and nonteaching medical services.教学医疗服务与非教学医疗服务之间资源利用和临床结果的比较。
J Hosp Med. 2007 May;2(3):150-7. doi: 10.1002/jhm.174.
8
The readmission rates in patients with versus those without diabetes mellitus at an urban teaching hospital.城市教学医院中糖尿病患者与非糖尿病患者的再入院率。
J Diabetes Complications. 2017 Dec;31(12):1681-1685. doi: 10.1016/j.jdiacomp.2017.07.006. Epub 2017 Jul 19.
9
Thirty-day readmissions in multiple sclerosis: An age and gender-based US national retrospective analysis.多发性硬化症 30 天再入院率:基于年龄和性别的美国全国回顾性分析。
Mult Scler Relat Disord. 2019 Jun;31:41-50. doi: 10.1016/j.msard.2019.03.012. Epub 2019 Mar 20.
10
Hospital bed utilization by teaching and nonteaching medical services.教学医疗服务和非教学医疗服务对医院病床的使用情况。
Health Care Manag (Frederick). 2012 Oct-Dec;31(4):295-301. doi: 10.1097/HCM.0b013e31826fe26c.

本文引用的文献

1
The HOSPITAL Score Predicts Potentially Preventable 30-Day Readmissions in Conditions Targeted by the Hospital Readmissions Reduction Program.医院评分可预测医院再入院减少计划所针对疾病中潜在可预防的30天再入院情况。
Med Care. 2017 Mar;55(3):285-290. doi: 10.1097/MLR.0000000000000665.
2
Patient outcomes in teaching versus nonteaching general internal medicine services: a systematic review and meta-analysis.教学与非教学普通内科服务中的患者结局:系统评价和荟萃分析。
Acad Med. 2014 Mar;89(3):517-23. doi: 10.1097/ACM.0000000000000154.
3
Predictors of rehospitalization among elderly patients admitted to a rehabilitation hospital: the role of polypharmacy, functional status, and length of stay.老年康复住院患者再住院的预测因素:药物使用种类、功能状态和住院时间的作用。
J Am Med Dir Assoc. 2013 Oct;14(10):761-7. doi: 10.1016/j.jamda.2013.03.013. Epub 2013 May 7.
4
Potentially avoidable 30-day hospital readmissions in medical patients: derivation and validation of a prediction model.医疗患者中潜在可避免的 30 天内再次住院:预测模型的推导和验证。
JAMA Intern Med. 2013 Apr 22;173(8):632-8. doi: 10.1001/jamainternmed.2013.3023.
5
Identifying hospital organizational strategies to reduce readmissions.确定降低再入院率的医院组织策略。
Am J Med Qual. 2013 Jul-Aug;28(4):278-85. doi: 10.1177/1062860612464999. Epub 2012 Nov 1.
6
Longer lengths of stay and higher risk of mortality among inpatients of physicians with more years in practice.行医年限较长的医生,其住院患者的住院时间更长,死亡率更高。
Am J Med. 2011 Sep;124(9):868-74. doi: 10.1016/j.amjmed.2011.04.011. Epub 2011 Jul 23.
7
Proportion of hospital readmissions deemed avoidable: a systematic review.医院再入院可避免比例的系统评价。
CMAJ. 2011 Apr 19;183(7):E391-402. doi: 10.1503/cmaj.101860. Epub 2011 Mar 28.
8
Relationship between early physician follow-up and 30-day readmission among Medicare beneficiaries hospitalized for heart failure.医疗保险受益人因心力衰竭住院后,与 30 天再入院相关的早期医生随访情况。
JAMA. 2010 May 5;303(17):1716-22. doi: 10.1001/jama.2010.533.
9
Rehospitalizations among patients in the Medicare fee-for-service program.医疗保险按服务收费项目参保患者的再次住院情况。
N Engl J Med. 2009 Apr 2;360(14):1418-28. doi: 10.1056/NEJMsa0803563.
10
A comparative study of unscheduled hospital readmissions in a resident-staffed teaching service and a hospitalist-based service.一项针对驻院医师教学服务模式与基于医院医师服务模式下非计划内医院再入院情况的对比研究。
South Med J. 2009 Feb;102(2):145-9. doi: 10.1097/SMJ.0b013e31818bc48a.