有自杀意念的年轻患者再次入院的相关影响、趋势和费用。
Effects, trends, costs associated with readmission in early-aged patients with suicidal ideation.
机构信息
Department of Pharmaceutical Outcomes and Policy College of Pharmacy, University of Florida, Gainesville, FL, USA.
Ecole Nationale Supérieure de Statistiques Et d'Economie Appliquée (ENSEA), Abidjan, Côte d'Ivoire.
出版信息
Expert Rev Pharmacoecon Outcomes Res. 2022 Mar;22(2):247-258. doi: 10.1080/14737167.2021.1914593. Epub 2021 May 3.
OBJECTIVE
To examine determinants, trends, and costs associated with 30-day all-cause readmission (R) for suicidal ideation (SI) in early-aged patients.
METHODS
This was a retrospective cohort study using the 2010-2014 Nationwide Readmissions Database. Discharge records for those aged 5-24 with an SI diagnosis were analyzed. Hierarchical models (HMs) were used to assess factors of R, length of stay (LOS), and total costs of Rs.
RESULTS
There were 197,603 SI index admissions (IAs). Of these, 2% had a R. The annualized trend of R rates for all age groups remained constant. Those aged 13-18 had the highest rate of Rs, while IA and R mean total costs were highest for those aged 5-12 (IA, $4,546-$5,822; R, $5,361-$7,113). The strongest risk factors for increasing R included nonelective admission and private hospital ownership. The strongest risk factors for increasing LOS and cost were major/extreme severity of illness and 30-day all-cause R. The intracluster correlation coefficient for the HMs were 0.06, 0.33, and 0.55 for the R, LOS, and cost model, respectively.
CONCLUSIONS
The R rate was highest for those in the 13-18 age group, while the costs were highest for those aged 5-12.
目的
研究与 5-24 岁年龄段患者自杀意念（SI）初次入院后 30 天内全因再入院（R）相关的决定因素、趋势和费用。
方法
这是一项回顾性队列研究，使用了 2010-2014 年全国再入院数据库。分析了有 SI 诊断的 5-24 岁患者的出院记录。采用分层模型（HM）评估 R、住院时间（LOS）和 R 总费用的影响因素。
结果
共有 197603 例 SI 指数入院（IA）。其中，2%的患者发生 R。所有年龄段的 R 率年化趋势保持不变。13-18 岁年龄组的 R 率最高，而 5-12 岁年龄组的 IA 和 R 的平均总费用最高（IA：4546-5822 美元；R：5361-7113 美元）。增加 R 的最强风险因素包括非选择性入院和私立医院所有权。增加 LOS 和费用的最强风险因素是严重程度为主要/极度严重和 30 天全因 R。HM 的组内相关系数分别为 0.06、0.33 和 0.55，用于 R、LOS 和成本模型。
结论
R 率最高的是 13-18 岁年龄组，而成本最高的是 5-12 岁年龄组。
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