Kayyali Reem, Funnell Gill, Odeh Bassel, Sharma Anuj, Katsaros Yannis, Nabhani-Gebara Shereen, Pierscionek Barbara, Wells Joshua Sterling, Chang John
Pharmacy, Kingston University Faculty of Science Engineering and Computing, Kingston Upon Thames, Surrey, UK
Pharmacy, Kingston University Faculty of Science Engineering and Computing, Kingston Upon Thames, Surrey, UK.
BMJ Open. 2020 Sep 2;10(9):e035522. doi: 10.1136/bmjopen-2019-035522.
This study forms the user requirements phase of the OPTIMAL project, which, through a predictive model and supportive intervention, aims to decrease early hospital readmissions. This phase aims to investigate the needs and characteristics of patients who had been admitted to hospital ≥2 times in the past 12 months.
This was a cross-sectional study involving patients from Croydon University Hospital (CUH), London, UK.
A total of 347 patients responded to a postal questionnaire, a response rate of 12.7%. To meet the inclusion criteria, participants needed to be aged ≥18 and have been admitted ≥2 times in the previous 12 months (August 2014-July 2015) to CUH.
To profile patients identified as frequent admitters to assess gaps in care at discharge or post-discharge. Additionally, to understand the patients' experience of admission, discharge and post-discharge care.
The range of admissions in the past 12 months was 2-30, with a mean of 2.8. At discharge 72.4% (n=231/347) were not given a contact for out-of-hours help. Regression analysis identified patient factors that were significantly associated with frequent admissions (>2 in 12 months), which included age (p=0.008), being in receipt of care (p=0.005) and admission due to a fall (p=0.01), but not receiving polypharmacy. Post-discharge, 41.8% (n=145/347) were concerned about being readmitted to the hospital. In the first 30 days after discharge, over half of patients (54.5% n=189/347) had no contact from a healthcare professional.
Considering that social care needs were more of a determinant of admission risk than medical needs, rectifying the lack of integration, communication and the under-utilisation of existing patient services could prevent avoidable problems during the transition of care and help decrease the likelihood of hospital readmission.
本研究构成了OPTIMAL项目的用户需求阶段，该项目旨在通过预测模型和支持性干预措施降低早期医院再入院率。此阶段旨在调查过去12个月内入院≥2次的患者的需求和特征。
这是一项横断面研究，涉及来自英国伦敦克罗伊登大学医院（CUH）的患者。
共有347名患者回复了邮寄问卷，回复率为12.7%。为符合纳入标准，参与者年龄需≥18岁，且在之前12个月（2014年8月至2015年7月）内入院≥2次至CUH。
对被确定为频繁入院患者进行分析，以评估出院时或出院后护理方面的差距。此外，了解患者入院、出院及出院后护理的体验。
过去12个月内入院次数范围为2至30次，平均为2.8次。出院时，72.4%（n = 231/347）的患者未获得非工作时间帮助的联系方式。回归分析确定了与频繁入院（12个月内>2次）显著相关的患者因素，包括年龄（p = 0.008）、接受护理（p = 0.005）和因跌倒入院（p = 0.01），但不包括接受多种药物治疗。出院后，41.8%（n = 145/347）的患者担心再次入院。出院后的前30天内，超过一半的患者（54.5%，n = 189/347）未与医护人员有过联系。
鉴于社会护理需求比医疗需求更能决定入院风险，纠正现有患者服务缺乏整合、沟通及利用不足的问题，可预防护理过渡期间的可避免问题，并有助于降低医院再入院的可能性。
