Fernández Gracia J, Martínez González M A, García Rodríguez J, Bueno Cavanillas A, Lardelli Claret P, García Martín M
Service de Medicina Preventiva, Hospital Universitario de Granada.
Med Clin (Barc). 1997 Jan 11;108(1):4-8.
To identify factors associated with hospital readmission, especially those potentially avoidable. This information could be useful to reduce the incidence of hospital readmissions.
A paired (1:1) case-control study nested into the cohort of first admissions at the Granada University Hospital, Spain, in 1990. All patients readmitted at the hospital within 3 years after release from the index-admission by the same diagnostic or complications of it comprised the case group. For each case, a control patient was matched for both primary diagnosis on admission and index-admission date. Information on risk factors associated with hospital readmission was obtained retrospectively from medical records. The relation between these risk factors and readmission was estimated from odds ratio both crude and adjusted using conditional logistic regression analysis. For the readmitted subsample, multiple linear regression models were applied to identify factors associated to the length of time between the index episode and the first readmission.
Variables with consistent positive associations with readmission include male sex (odds ratio = 2.86, 95% confidence interval = 1.37-5.88), widowed or single status (2.66, 10.7-6.59) and severity at index admission (3.20, 1.57-6.51). Factors related to quality of health care did not influence readmission risk.
Factors depending of the patient seem to be the most important variables associated to the incidence of hospital readmission.
确定与医院再入院相关的因素，尤其是那些可能避免的因素。这些信息可能有助于降低医院再入院率。
一项配对（1:1）病例对照研究嵌套于1990年西班牙格拉纳达大学医院首次入院的队列中。所有在首次入院出院后3年内因相同诊断或其并发症再次入院的患者组成病例组。对于每个病例，匹配一名对照患者，其入院时的主要诊断和首次入院日期均相同。与医院再入院相关的危险因素信息通过回顾医疗记录获得。使用条件逻辑回归分析，从粗比值比和调整后的比值比估计这些危险因素与再入院之间的关系。对于再入院的子样本，应用多元线性回归模型来确定与首次入院至首次再入院之间的时间长度相关的因素。
与再入院始终呈正相关的变量包括男性（比值比=2.86，95%置信区间=1.37-5.88）、丧偶或单身状态（2.66，1.07-6.59）以及首次入院时的病情严重程度（3.20，1.57-6.51）。与医疗质量相关的因素并未影响再入院风险。
取决于患者的因素似乎是与医院再入院发生率相关的最重要变量。
