Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Asan, Republic of Korea.
Center for Healthcare Management Science, Soonchunhyang University, Asan, Republic of Korea.
Int J Health Policy Manag. 2023;12:7390. doi: 10.34172/ijhpm.2023.7390. Epub 2023 Jul 24.
Pneumonia is one of the leading causes of hospital admission in the United States with a global health burden of about 6.8 million hospitalizations and 1.1 million deaths in patients over 65 years old in 2015. This study aimed to identify possible patient and hospital-related risk factors for in-hospital pneumonia death across US hospitals.
The National Inpatient Sample (NIS) was used to identify nationwide pneumonia patients (n=374 766, weighted n=1 873 828) from 2016 to 2019. We examined the characteristics of the study sample and their association with in-hospital death. Multivariate survey logistic regression models were used to identify risk factors.
During the study periods, in-hospital death rates continuously decreased (2.45% in 2016 to 2.19% in 2019). Descriptive statistics showed that patient and hospital factors had varied in-hospital death rates. Survey logistic regression results suggested that male, very low income, non-Medicare, government hospitals, rural hospitals, and specific hospital regions were associated with higher in-hospital death rates than their reference groups.
Socioeconomic factors, including income and insurance, are associated with pneumonia mortality. Census region, hospital ownership, and rural location are also related to in-hospital mortality. Such findings in underserved, impoverished, and rural areas to identify possible health disparities.
肺炎是导致美国住院的主要原因之一，2015 年，全球有 680 万人因肺炎住院，65 岁以上患者中有 110 万人因肺炎死亡。本研究旨在确定美国医院内肺炎死亡的可能与患者和医院相关的危险因素。
本研究使用国家住院患者样本（NIS）确定了 2016 年至 2019 年期间全国范围内的肺炎患者（n=374766，加权 n=1873828）。我们检查了研究样本的特征及其与院内死亡的关系。采用多变量调查逻辑回归模型确定危险因素。
在研究期间，院内死亡率持续下降（2016 年为 2.45%，2019 年为 2.19%）。描述性统计数据显示，患者和医院因素的院内死亡率存在差异。调查逻辑回归结果表明，男性、极低收入、非医疗保险、政府医院、农村医院和特定医院区域的院内死亡率高于其参考组。
社会经济因素，包括收入和保险，与肺炎死亡率有关。普查区域、医院所有权和农村地区也与院内死亡率有关。这些发现可能表明在服务不足、贫困和农村地区存在健康差距。
