Division of Hospital Medicine, University of California, San Francisco, 521 Parnassus Avenue, San Francisco, CA, 94143, USA.
Division of General Internal Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, 1001 Potrero Ave, San Francisco, 94110, CA, USA.
J Racial Ethn Health Disparities. 2022 Aug;9(4):1500-1505. doi: 10.1007/s40615-021-01088-3. Epub 2021 Jun 28.
Health systems have targeted hospital readmissions to promote health equity as there may be racial and ethnic disparities across different patient groups. However, 7-day readmissions have been understudied in adult hospital medicine.
This is a retrospective study. We performed multivariable logistic regression between patient race/ethnicity and 7-day readmission. Mediation analysis was performed for limited English proficiency (LEP) status. Subgroup analyses were performed for patients with initial admissions for congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and cancer.
We identified all adults discharged from the adult hospital medicine service at UCSF Medical Center between July 2016 and June 2019.
The primary outcome was 7-day all-cause readmission back to the discharging hospital.
There were 18,808 patients in our dataset who were discharged between July 2016 and June 2019. A total of 1,297 (6.9%) patients were readmitted within 7 days. Following multivariable regression, patients who identified as Black (OR 1.35, 95% CI 1.15-1.58, p <0.001) and patients who identified as Asian (OR 1.26, 95% CI 1.06-1.50, p = 0.008) had higher odds of readmission compared to white patients. Multivariable regression at the subgroup level for CHF, COPD, and cancer readmissions did not demonstrate significant differences between the racial and ethnic groups.
Black patients and Asian patients experienced higher rates of 7-day readmission than patients who identified as white, confirmed on adjusted analysis.
卫生系统已将医院再入院作为促进健康公平的目标，因为不同患者群体之间可能存在种族和民族差异。然而，成人医院医学对 7 天再入院的研究较少。
这是一项回顾性研究。我们在患者种族/民族与 7 天再入院之间进行了多变量逻辑回归。对于英语水平有限（LEP）状况进行了中介分析。对充血性心力衰竭（CHF）、慢性阻塞性肺疾病（COPD）和癌症初始入院的患者进行了亚组分析。
我们确定了 2016 年 7 月至 2019 年 6 月期间在 UCSF 医疗中心成人医院医学科出院的所有成年人。
主要结果是返回出院医院的 7 天全因再入院。
在我们的数据集里，有 18808 名患者在 2016 年 7 月至 2019 年 6 月间出院。共有 1297 名（6.9%）患者在 7 天内再次入院。在多变量回归后，与白人患者相比，黑人（OR 1.35，95%CI 1.15-1.58，p<0.001）和亚裔（OR 1.26，95%CI 1.06-1.50，p=0.008）患者的再入院可能性更高。CHF、COPD 和癌症再入院的亚组水平的多变量回归并未显示出不同种族和民族之间的显著差异。
在调整后的分析中，黑人患者和亚裔患者的 7 天再入院率高于白人患者。
