Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul 02447, Korea.
Department of Medical Education and Humanities, School of Medicine, Kyung Hee University, Seoul 02447, Korea.
Int J Environ Res Public Health. 2020 Aug 12;17(16):5844. doi: 10.3390/ijerph17165844.
In South Korea, 4.5% patients of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were readmitted to hospitals after discharge. However, there is insufficient research on risk factors for readmission and management of patients after discharge is poor. In this study, 7590 confirmed coronavirus disease (COVID-19) patients were defined as a target for analysis using nationwide medical claims data. The demographic characteristics, underlying diseases, and the use of medical resources were used to examine the association with readmission through the chi-square test and then logistic regression analysis was performed to analyze factors affecting readmission. Of the 7590 subjects analyzed, 328 patients were readmitted. The readmission rates of men, older age and patients with medical benefits showed a high risk of readmission. The Charlson Comorbidity Index score was also related to COVID-19 readmission. Concerning requiring medical attention, there was a higher risk of readmission for the patients with chest radiographs, computed tomography scans taken and lopinavir/ritonavir at the time of their first admission. Considering the risk factors presented in this study, classifying patients with a high risk of readmission and managing patients before and after discharge based on priority can make patient management and medical resource utilization more efficient. This study also indicates the importance of lifestyle management after discharge.
在韩国，有 4.5%的严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 患者出院后会再次住院。然而，对于再次住院的风险因素的研究还不够充分，并且出院后的患者管理也很差。在这项研究中，使用全国性的医疗报销数据，将 7590 名确诊的新型冠状病毒病 (COVID-19) 患者定义为分析对象。通过卡方检验检查与再次住院相关的人口统计学特征、基础疾病和医疗资源使用情况，然后进行逻辑回归分析，以分析影响再次住院的因素。在分析的 7590 名患者中，有 328 名患者再次住院。男性、年龄较大和享受医疗福利的患者再次住院的风险较高。Charlson 合并症指数评分也与 COVID-19 再次住院有关。就需要医疗关注而言，在首次入院时进行胸部 X 光检查、计算机断层扫描检查和洛匹那韦/利托那韦的患者再次住院的风险更高。考虑到本研究中呈现的风险因素，可以根据优先级对有再次住院高风险的患者进行分类，并在出院前后进行管理，从而使患者管理和医疗资源利用更加高效。本研究还表明出院后生活方式管理的重要性。
