Brooten D, Naylor M, Brown L, York R, Hollingsworth A, Cohen S, Roncoli M, Jacobsen B
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA.
Public Health Nurs. 1996 Apr;13(2):128-34. doi: 10.1111/j.1525-1446.1996.tb00230.x.
The study's purpose was to examine postdischarge rehospitalizations and acute care visits in seven high risk, high volume, high-cost patient groups. Subjects were drawn from an urban tertiary teaching hospital. The total sample (N = 764) consisted of seven patient groups (drawn from five randomized clinical trials): very low birthweight (VLBW) infants (n = 79); women post-unplanned cesarean birth (n = 122) and their infants (n = 123); pregnant women with diabetes (n = 55); women post-hysterectomy surgery (n = 109); and elderly with medical cardiac Diagnostic Related Groups (DRGs) (n = 142) and elderly with surgical cardiac DRGs (n = 134). The VLBW infant and pregnant diabetic groups were predominantly African American, the elderly and hysterectomy groups predominantly Caucasian, and the cesarean group almost equally distributed. The lowest rate of rehospitalization (2%) occurred in the cesarean group, the highest (35%) in the pregnant diabetics. In four groups (cesarean and infants, hysterectomy and surgical elderly), 60%-100% of the rehospitalizations occurred within 4 weeks of discharge. Subjects requiring acute care visits ranged from 13% (hysterectomy) to 82% (VLBW infants). Acute care visits demonstrated greater distribution throughout the follow-up periods but also tended to concentrate in the first 4 weeks postdischarge.
该研究的目的是调查七个高风险、高容量、高成本患者群体出院后的再次住院情况和急诊就诊情况。研究对象来自一家城市三级教学医院。总样本（N = 764）包括七个患者群体（来自五项随机临床试验）：极低出生体重（VLBW）婴儿（n = 79）；非计划剖宫产术后妇女（n = 122）及其婴儿（n = 123）；患有糖尿病的孕妇（n = 55）；子宫切除术后妇女（n = 109）；患有内科心脏诊断相关组（DRGs）的老年人（n = 142）以及患有外科心脏DRGs的老年人（n = 134）。极低出生体重婴儿组和患有糖尿病的孕妇组主要为非裔美国人，老年组和子宫切除组主要为白种人，剖宫产组的种族分布几乎均等。再次住院率最低的是剖宫产组（2%），最高的是患有糖尿病的孕妇组（35%）。在四个组（剖宫产及其婴儿组、子宫切除组和外科老年组）中，60% - 100%的再次住院发生在出院后4周内。需要急诊就诊的受试者比例从13%（子宫切除组）到82%（极低出生体重婴儿组）不等。急诊就诊在整个随访期间分布更广，但也倾向于集中在出院后的前4周。
