Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan.
Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, Taiwan.
BMC Health Serv Res. 2023 Mar 10;23(1):236. doi: 10.1186/s12913-023-09220-1.
Previous studies showed that same-hospital readmission is associated with better outcomes than different-hospital readmission. However, little is known about whether readmission to the same care unit (same-care unit readmission) after infectious hospitalization performs better than readmission to a different care unit at the same hospital (different-care unit readmission).
This retrospective study screened patients rehospitalized within 30 days following admission to two acute medical wards for infectious diseases from 2013 to 2015 and included only those readmitted for unplanned medical reasons. Outcomes of interest included hospital mortality and length of stay of readmitted patients.
Three hundred and fifteen patients were included; of those, 149(47%) and 166(53%) were classified as same-care unit and different-care unit readmissions, respectively. Same-care unit patients were more likely to be older(76 years vs. 70 years; P = 0.001), have comorbid chronic kidney disease(20% vs. 9%; P = 0.008), and have a shorter time to readmission(13 days vs. 16 days; P = 0.020) than different-care unit patients. Univariate analysis showed that same-care unit patients had a shorter length of stay than different-care unit patients(13 days vs. 18 days; P = 0.001), but had similar hospital mortality(20% vs. 24%; P = 0.385). The multivariable linear regression model indicated that same-care unit readmission was associated with a 5-day shorter hospital stay than different-care unit readmission(P = 0.002).
Among patients readmitted within 30 days after hospitalization for infectious diseases, same-care unit readmission was associated with a shorter length of hospital stay than different-care unit readmission. Whenever feasible, it is encouraged to allocate a readmitted patient to the same care unit in hope of pursuing continuity and quality of care.
先前的研究表明，同一医院的再入院率优于不同医院的再入院率。然而，对于感染性住院后再入院至同一护理单元（同一护理单元再入院）是否优于同一医院的不同护理单元（不同护理单元再入院），人们知之甚少。
本回顾性研究筛选了 2013 年至 2015 年期间在两个急性内科传染病病房住院后 30 天内再次住院的患者，并仅纳入因非计划性医疗原因再次入院的患者。感兴趣的结果包括再入院患者的医院死亡率和住院时间。
共纳入 315 例患者；其中，149 例（47%）和 166 例（53%）分别归类为同一护理单元和不同护理单元再入院。与不同护理单元患者相比，同一护理单元患者年龄更大（76 岁比 70 岁；P=0.001）、合并慢性肾脏病的比例更高（20%比 9%；P=0.008）、再入院时间更短（13 天比 16 天；P=0.020）。单因素分析显示，同一护理单元患者的住院时间短于不同护理单元患者（13 天比 18 天；P=0.001），但医院死亡率相似（20%比 24%；P=0.385）。多变量线性回归模型表明，同一护理单元再入院与不同护理单元再入院相比，住院时间缩短 5 天（P=0.002）。
在感染性疾病住院后 30 天内再次入院的患者中，同一护理单元再入院与不同护理单元再入院相比，住院时间更短。只要可行，应鼓励将再次入院的患者分配至同一护理单元，以追求护理的连续性和质量。
