Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
Department of Nursing, Skellefteå Campus, Umeå University, Umeå, Sweden.
Scand J Prim Health Care. 2021 Mar;39(1):92-100. doi: 10.1080/02813432.2021.1882086. Epub 2021 Feb 11.
Patients in Sweden's rural community hospitals have not been clinically characterised. We compared characteristics of patients in general practitioner-led community hospitals in northern Sweden with those admitted to general hospitals.
Retrospective register study.
Community and general hospitals in Västerbotten and Norrbotten counties, Sweden.
Patients enrolled at community hospitals and hospitalised in community and general hospitals between 1 January 2010 and 31 December 2014.
Age, sex, number of admissions, main, secondary and total number of diagnoses.
We recorded 16,133 admissions to community hospitals and 60,704 admissions to general hospitals. Mean age was 76.8 and 61.2 years for community and general hospital patients ( < .001). Women were more likely than men to be admitted to a community hospital after age adjustment (odds ratio (OR): 1.11; 95% confidence interval (CI): 1.09-1.17). The most common diagnoses in community hospital were heart failure (6%) and pneumonia (5%). Patients with these diagnoses were more likely to be admitted to a community than a general hospital (OR: 2.36; 95% CI: 2.15-2.59; vs. OR: 3.32: 95% CI: 2.77-3.98, respectively, adjusted for age and sex). In both community and general hospitals, doctors assigned more diagnoses to men than to women (both <.001).
Patients at community hospitals were predominantly older and women, while men were assigned more diagnoses. The most common diagnoses were heart failure and pneumonia. Our observed differences should be further explored to define the optimal care for patients in community and general hospitals.Key pointsThe patient characteristics at Swedish general practitioner-led rural community hospitals have not yet been reported. This study characterises inpatients in community hospitals compared to those referred to general hospitals.• Patients at community hospitals were predominantly older, with various medical conditions that would have led to a referral to general hospitals elsewhere in Sweden. • Compared to men, women were more likely to be admitted to community hospitals than to general hospitals, even after adjustment for age. To the best of our knowledge, this pattern has not been reported in other countries with community hospitals. • In both community hospitals and general hospitals, doctors assigned more diagnoses to men than to women.
瑞典农村社区医院的患者尚未进行临床特征描述。我们比较了瑞典北博滕和诺尔兰郡以全科医生为主导的社区医院患者与综合医院入院患者的特征。
回顾性登记研究。
瑞典北博滕和诺尔兰郡的社区和综合医院。
2010 年 1 月 1 日至 2014 年 12 月 31 日期间在社区医院就诊并在社区和综合医院住院的患者。
年龄、性别、住院次数、主要诊断、次要诊断和总诊断数。
我们记录了 16133 例社区医院入院和 60704 例综合医院入院。社区和综合医院患者的平均年龄分别为 76.8 岁和 61.2 岁（均<.001）。女性在年龄调整后比男性更有可能被收入社区医院（优势比（OR）：1.11；95%置信区间（CI）：1.09-1.17）。社区医院最常见的诊断是心力衰竭（6%）和肺炎（5%）。这些诊断的患者更有可能被收入社区医院而不是综合医院（OR：2.36；95%CI：2.15-2.59；OR：3.32；95%CI：2.77-3.98，分别调整年龄和性别）。在社区和综合医院中，医生为男性分配的诊断都多于女性（均<.001）。
社区医院的患者主要为老年人和女性，而男性被分配了更多的诊断。最常见的诊断是心力衰竭和肺炎。我们观察到的差异应进一步探讨，以确定社区和综合医院患者的最佳治疗方案。
瑞典以全科医生为主导的农村社区医院的患者特征尚未报道。本研究对社区医院的住院患者与转至综合医院的患者进行了比较。
• 社区医院的患者主要为年龄较大且患有各种医疗状况的患者，这些患者本应被转至瑞典其他地方的综合医院治疗。
• 与男性相比，女性更有可能被收入社区医院，即使在调整年龄后也是如此。据我们所知，这种模式在其他设有社区医院的国家尚未有报道。
• 在社区医院和综合医院中，医生为男性分配的诊断都多于女性。
