Karolinska Institutet, Stockholm, Sweden.
FOU nu, Research and Development Center for the Elderly, Region Stockholm, Järfälla, Sweden.
J Prim Care Community Health. 2024 Jan-Dec;15:21501319241277413. doi: 10.1177/21501319241277413.
INTRODUCTION/OBJECTIVES: Primary health care visits post-discharge could potentially play an important role in efforts of reducing hospital readmission. Focusing on a single or a particular type of visit obscures nuances in types of primary care contacts over time and fails to quantify the intensity of primary health care visits during the follow-up period. The aim of this study was to explore associations between the number and type of primary health care visits post-discharge and the risk of hospital readmission within 30 days.
A register-based closed cohort study. The study population of 6135 individuals were residents of Stockholm who were discharged home from any of the 3 geriatric inpatient departments, excluding those who were readmitted within the next 24 h. The dependent variable was hospital readmission within 30 days of discharge. The key independent variable was the number and type of primary health care visits in 30 days post-discharge. Cox-regression with time-varying covariates was employed for data analyses.
Approximately, 12% of the participants were readmitted to hospital within 30 days. There was no statistically significant association between number of primary care visits post-discharge and readmission (HR 1.00; 95% CI 1.00-1.01). Compared to no primary health care visit, no statistically significant association were found for administrative care related visits (HR 0.33, 95%CI 0.08-1.33), clinic visits (HR 0.93, 95%CI 0.71-1.21), home visits (HR 1.03, 95%CI 0.84-1.27), or team visits (HR 0.76, 95%CI 0.54-1.07).
There were no associations between primary health care visits post-discharge and hospital readmission after geriatric inpatient care. Further studies using survey or qualitative approaches can provide insights into the factors that are relevant to post-discharge care but are unavailable in this type of register data studies.
引言/目的：出院后的初级保健就诊可能在降低医院再入院率方面发挥重要作用。关注单次或特定类型的就诊会掩盖随时间推移的初级保健就诊类型的细微差别，并且无法量化随访期间初级保健就诊的强度。本研究旨在探讨出院后初级保健就诊的数量和类型与 30 天内医院再入院风险之间的关联。
基于登记的封闭队列研究。研究人群为 6135 名居住在斯德哥尔摩的个体，他们从 3 个老年住院病房中的任何一个出院回家，但不包括在接下来的 24 小时内再次入院的患者。因变量是出院后 30 天内的医院再入院。主要的独立变量是出院后 30 天内的初级保健就诊次数和类型。采用时变协变量的 Cox 回归进行数据分析。
大约 12%的参与者在 30 天内再次住院。出院后初级保健就诊次数与再入院之间无统计学显著关联（HR 1.00；95%CI 1.00-1.01）。与没有初级保健就诊相比，行政护理相关就诊（HR 0.33，95%CI 0.08-1.33）、诊所就诊（HR 0.93，95%CI 0.71-1.21）、家庭就诊（HR 1.03，95%CI 0.84-1.27）或团队就诊（HR 0.76，95%CI 0.54-1.07）均无统计学显著关联。
出院后初级保健就诊与老年住院患者的医院再入院之间没有关联。使用调查或定性方法的进一步研究可以深入了解与出院后护理相关但在这种类型的登记数据研究中无法获得的因素。
