Peiró S, Librero J, Benages Martínez A
Unitat d'Investigació en Serveis de Salut, Institut Valencià d'Estudis en Salut Pública.
Med Clin (Barc). 1996 Jun 1;107(1):4-13.
To describe the epidemiological characteristics of emergency readmissions due to digestive and hepatobiliary diseases within the hospitals of the Valencian Health Service (VHS), Spain, and to examine their relationship with defined variables related to patients or to previous periods of hospitalization.
Out of the 212,947 episodes of patient hospitalization included in the Uniform Hospital Discharge Data Set of the VHS, excluding those persons under 16 years of age, those who had died in hospital or were discharged due to being transferred to another hospital and also excluding the two hospitals whose record were of poor quality, 18,075 patients were chosen whose principal diagnosis on first admission was one of a digestive or hepatobiliary disease. After a descriptive analysis the relationship was explored between risk of readmission and the variables of age, gender, hospital funding, whether the environment is a rural or urban one, the hospital itself, the diagnostic group, comorbidity, type of admission, length of stay, presence of surgical procedure, discharge criteria and service using an independent Cox Proportional Hazards analysis for each variable and a second Cox analysis adjusted for selected variables.
16.9% of those patients discharged for digestive disorders are re-admitted within a year. The risk of readmission is associated with age, comorbidity, male sex and chronic diseases and, with respect to the previous episode of hospitalization, it is associated with emergency admission, longer period of hospitalization, non-surgical discharge and admission to certain hospitals.
The risk of emergency readmission is associated with defined variables relating to patient or previous episodes of hospitalization connected with a more serious condition. The risk adjustment carried out could be used in order to identify high-risk cases which could then be paid special attention in order to delay or prevent readmission and as an indirect indicator for use in monitoring the quality of hospital care.
描述西班牙巴伦西亚卫生服务局（VHS）下属医院因消化和肝胆疾病导致的急诊再入院的流行病学特征，并研究其与患者相关或与既往住院期间相关的特定变量之间的关系。
在VHS统一医院出院数据集所包含的212,947例患者住院病例中，排除16岁以下患者、在医院死亡或因转院而出院的患者，以及记录质量较差的两家医院，选择18,075例首次入院主要诊断为消化或肝胆疾病的患者。经过描述性分析后，采用独立的Cox比例风险分析对每个变量进行再入院风险与年龄、性别、医院资金、环境是农村还是城市、医院本身、诊断组、合并症、入院类型、住院时间、是否进行手术、出院标准和服务等变量之间关系的探讨，并对选定变量进行调整后进行第二次Cox分析。
因消化系统疾病出院的患者中有16.9%在一年内再次入院。再入院风险与年龄、合并症、男性性别和慢性病有关，就既往住院情况而言，与急诊入院、住院时间较长、非手术出院以及入住某些医院有关。
急诊再入院风险与患者相关或与既往住院期间相关的特定变量有关，这些变量与病情更严重的情况相关。所进行的风险调整可用于识别高危病例，进而对其给予特别关注以延迟或预防再入院，并作为监测医院护理质量的间接指标。
