School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS, Australia.
School of Nursing and Midwifery, University of Newcastle, Port Macquarie, NSW, Australia.
Int J Health Policy Manag. 2022 Dec 6;11(11):2533-2541. doi: 10.34172/ijhpm.2022.5770. Epub 2022 Jan 9.
This study aimed to investigate the prevalence of hospital readmission for chronic obstructive pulmonary disease (COPD) at 30, 90 and 365 days, and to determine demographic and socioeconomic risk factors for 30-day and 90-day readmission and time to COPD-related readmission within 365 days in Tasmania.
Patients ≥40 years admitted for COPD between 2011 and 2015 were identified using administrative data from all major public hospitals in Tasmania, Australia. Factors associated with readmission and time to readmission were identified using logistic and Cox regression, respectively.
The rates of COPD-related readmission were 6.7% within 30 days, 12.2% within 90 days and 23.7% within 365 days. Being male (odds ratio [OR]: 1.49, CI: 1.06-2.09), Indigenous (OR: 2.47, CI: 1.31-4.66) and living in the lower socioeconomic North-West region of Tasmania (OR: 1.80, CI: 1.20-2.69) were risk factors for 30-day readmission. Increased COPD-related (OR: 1.48, CI: 1.22-1.80; OR: 1.52, CI: 1.29-1.78) and non-COPD-related (OR: 1.12, CI: 1.03- 1.23; OR: 1.11, CI: 1.03-1.21) emergency department (ED) visits in the preceding six months were risk factors for both 30-day and 90-day readmissions. Being Indigenous (hazard ratio [HR]: 1.61, CI: 1.10-2.37) and previous COPD-related ED visits (HR: 1.30, CI: 1.21-1.39) decreased, while a higher Charlson Comorbidity Index (CCI) (OR: 0.91, CI: 0.83- 0.99) increased the time to readmission within 365 days.
Being male, Indigenous, living in the North-West region and previous ED visits were associated with increased risk of COPD readmission in Tasmania. Interventions to improve access to primary healthcare for these groups may reduce COPD-related readmissions.
本研究旨在调查塔斯马尼亚州慢性阻塞性肺疾病（COPD）患者在 30、90 和 365 天的住院再入院率，并确定 COPD 患者在 30 天和 90 天的再入院和 COPD 相关再入院时间的人口统计学和社会经济风险因素。
使用来自澳大利亚塔斯马尼亚州所有主要公立医院的行政数据，确定 2011 年至 2015 年间因 COPD 住院的年龄≥40 岁的患者。使用逻辑回归和 Cox 回归分别确定再入院和再入院时间的相关因素。
30 天内 COPD 相关再入院率为 6.7%，90 天内为 12.2%，365 天内为 23.7%。男性（比值比[OR]：1.49，CI：1.06-2.09）、原住民（OR：2.47，CI：1.31-4.66）和居住在塔斯马尼亚州社会经济水平较低的西北地区（OR：1.80，CI：1.20-2.69）是 30 天再入院的危险因素。增加 COPD 相关（OR：1.48，CI：1.22-1.80；OR：1.52，CI：1.29-1.78）和非 COPD 相关（OR：1.12，CI：1.03-1.23；OR：1.11，CI：1.03-1.21）急诊科（ED）就诊在过去六个月是 30 天和 90 天再入院的危险因素。原住民（风险比[HR]：1.61，CI：1.10-2.37）和之前的 COPD 相关 ED 就诊（HR：1.30，CI：1.21-1.39）减少，而较高的 Charlson 合并症指数（CCI）（OR：0.91，CI：0.83-0.99）增加了 365 天内的再入院时间。
男性、原住民、居住在西北地区和之前的 ED 就诊与塔斯马尼亚 COPD 再入院风险增加有关。为这些群体改善初级保健服务的机会可能会减少 COPD 相关的再入院。
