The impact of multiple chronic diseases on hospitalizations for ambulatory care sensitive conditions
The impact of multiple chronic diseases on hospitalizations for ambulatory care sensitive conditions
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DOI：
10.1186/s12913-016-1584-2
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发表时间：
2016-08-04
影响因子：
2.8
通讯作者：
Aguiar, Pedro
中科院分区：
文献类型：
--
作者：
Dantas, Ines;Santana, Rui;Aguiar, Pedro
背景资料：可避免的住院治疗的高经济负担导致了对门诊护理敏感性疾病（ACSC）住院治疗的研究增加。关于二次诊断对这些住院的影响的信息有限，尽管文献中经常将患者的社会和人口统计学特征以及多种疾病共存确定为可避免住院的风险因素。本研究探讨了慢性疾病的可能性ACSC.Methods住院治疗的影响：数据提取自葡萄牙医院出院数据库。根据加拿大医疗保健信息研究所确定避免住院，并根据医疗保健研究和质量机构制定的标准确定慢性疾病。一项回顾性研究分析了所有因ACSC住院的患者和所有因非ACSC住院的患者，使用多元logistic回归模型确定慢性疾病对入院风险的影响。（95% CI [1.34; 1.35]），以及1.55（95% CI [1.55; 1.56]）。呼吸系统和循环系统对ACSC的风险影响最大，分别增加了8.72（95%CI [8.58; 8.86]）和3.01（95%CI [2.95; 3.06]），结论：慢性疾病和身体系统受累的数量增加了ACSC住院的风险。
Background: The high financial burden of avoidable hospitalizations has led to an increase of the study of hospitalizations for ambulatory care sensitive conditions (ACSC). There is limited information on the impact of secondary diagnoses on these hospitalizations, although patients' social and demographic characteristics, as well as the coexistence of multiple diseases are often identified in the literature as risk factors for avoidable hospitalizations. This study explores the impact of chronic conditions on the likelihood of hospitalizations for ACSC.Methods: Data were extracted from the Portuguese hospital discharge database. Avoidable hospitalizations were identified according to the Canadian Institute for Healthcare Information, and chronic conditions were identified according to criteria set by the Agency for Healthcare Research and Quality. A retrospective study analysing all patients hospitalized for an ACSC and all patients hospitalized for non-ACSC was made, using multiple logistic regression models to identify the impact of chronic conditions on the risk of admission.Results: The risk of an avoidable hospitalization increases by a factor of 1.35 (95 % CI [1.34; 1.35]) for each additional chronic condition, and 1.55 (95 % CI [1.55; 1.56]) for each additional body system affected. The respiratory and circulatory systems have the most impact on the risk of ACSC, increasing the risk by 8.72 (95 % CI [8.58; 8.86]) and 3.01 (95 % CI [2.95; 3.06]), respectively.Conclusions: The number of chronic conditions and the body systems affected increase the risk of hospital admissions for ACSC.