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整合定量数据与定性见解以了解30天再入院率:一项混合方法研究。

Integrating Quantitative Data and Qualitative Insights to Understand 30-Day Readmission Rates: A Mixed-Methods Study.

作者信息

Allam Samy

机构信息

Medical Education, California University of Science and Medicine (CUSM), Colton, USA.

出版信息

Cureus. 2024 Oct 22;16(10):e72111. doi: 10.7759/cureus.72111. eCollection 2024 Oct.

Abstract

The rate of patients readmitted to hospitals within 30 days of discharge is a critical indicator of healthcare quality. This study explored the factors contributing to 30-day hospital readmission rates nationally and at Arrowhead Regional Medical Center (ARMC) through a mixed-methods research design. Quantitative analysis utilized data from the Centers for Medicare & Medicaid Services (CMS) database, focusing on patient demographics, principal diagnoses, length of stay, and hospital characteristics. Multivariate regression and descriptive statistics were employed to identify predictors of 30-day readmission. The qualitative analysis sought to understand the specific medical conditions and patient profiles linked to higher readmission rates. The findings revealed that older age, specific principal diagnoses (e.g., heart failure, pneumonia, chronic obstructive pulmonary disease (COPD)), and longer initial hospital stays were associated with an increased likelihood of 30-day readmission. Gender disparities and hospital size/type also influenced readmission rates. These results provide valuable insights into the complex interplay of individual patient characteristics and hospital attributes in driving readmissions. The study's mixed-methods approach yielded a comprehensive understanding of the quantitative patterns and qualitative factors contributing to 30-day hospital readmission rates, offering important implications for healthcare quality improvement initiatives.

摘要

出院后30天内再次入院的患者比例是医疗质量的关键指标。本研究通过混合研究设计,探讨了全国范围内以及箭头区域医疗中心(ARMC)30天再入院率的影响因素。定量分析使用了医疗保险和医疗补助服务中心(CMS)数据库的数据,重点关注患者人口统计学、主要诊断、住院时间和医院特征。采用多元回归和描述性统计来确定30天再入院的预测因素。定性分析旨在了解与较高再入院率相关的具体医疗状况和患者概况。研究结果显示,年龄较大、特定的主要诊断(如心力衰竭、肺炎、慢性阻塞性肺疾病(COPD))以及较长的首次住院时间与30天再入院可能性增加相关。性别差异以及医院规模/类型也会影响再入院率。这些结果为个体患者特征和医院属性在导致再入院方面的复杂相互作用提供了有价值的见解。该研究的混合方法全面理解了导致30天再入院率的定量模式和定性因素,为医疗质量改进举措提供了重要启示。

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