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功能状态和生物标志物对老年患者住院费用及再入院率的影响:一项采用综合老年评估的观察性研究

Impact of functional status and biomarkers on hospital costs and readmission rates in geriatric patients: An observational study with comprehensive geriatric assessment.

作者信息

Simonetti Irene, Landi Stefano, Leardini Chiara, Giani Anna, Bortolani Arianna, Fantin Francesco

机构信息

Economics and Business, University of Amsterdam, The Netherlands.

Department of Management, University of Verona, Verona, Italy.

出版信息

PLoS One. 2025 May 29;20(5):e0324465. doi: 10.1371/journal.pone.0324465. eCollection 2025.

Abstract

This study aimed to analyze the association between functional status, biomarkers, and hospitalization characteristics on costs and the probability of re-admission at 30 and 180 days in geriatric patients. It is used an observational design with both administrative data and additional clinical data not usually collected. Multivariate linear regression for hospitalization costs and multivariate logistic regressions for readmissions were used. Variables studied included the Barthel Index, Charlson index, albumin and blood pressure levels, previous hospitalizations, length of stay (LoS), and controls. Data from 953 patients aged over 65, admitted to the Geriatric ward between September 1st, 2018, and December 31st, 2019, were analyzed. The Charlson comorbidity index, number of comorbidities, and LoS were positively related to hospitalization costs. Previous hospitalizations and LoS were the main predictors of readmission. Systolic blood pressure was negatively associated with the odds of re-admission but showed no association with hospital costs. Higher functional status, as measured by the Barthel index, was linked to lower odds of unplanned hospitalization but was not statistically significant for costs. Functional status and biomarkers had moderate effects on costs and readmission odds. These findings can aid in early healthcare planning and resource management, providing valuable information for prioritizing patients and designing cost-effective care interventions.

摘要

本研究旨在分析老年患者功能状态、生物标志物、住院特征与30天和180天费用及再入院概率之间的关联。采用了一种观察性设计,纳入了行政数据和通常未收集的额外临床数据。使用多元线性回归分析住院费用,使用多元逻辑回归分析再入院情况。研究变量包括巴氏指数、查尔森指数、白蛋白和血压水平、既往住院史、住院时长(LoS)以及对照。分析了2018年9月1日至2019年12月31日期间入住老年病房的953例65岁以上患者的数据。查尔森合并症指数、合并症数量和住院时长与住院费用呈正相关。既往住院史和住院时长是再入院的主要预测因素。收缩压与再入院几率呈负相关,但与住院费用无关。以巴氏指数衡量的较高功能状态与非计划住院几率较低相关,但对费用无统计学显著影响。功能状态和生物标志物对费用和再入院几率有中等程度影响。这些发现有助于早期医疗规划和资源管理,为患者优先级排序和设计具有成本效益的护理干预措施提供有价值的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8c79/12121913/1ed16e059099/pone.0324465.g001.jpg

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