Hospital Readmission Rates in US States: Are Readmissions Higher Where More Patients with Multiple Chronic Conditions Cluster?
Hospital Readmission Rates in US States: Are Readmissions Higher Where More Patients with Multiple Chronic Conditions Cluster?
复制标题
DOI：
10.1111/1475-6773.12401
复制
发表时间：
2016-06-01
影响因子：
3.4
通讯作者：
Ricciardi, Richard
中科院分区：
文献类型：
--
作者：
Basu, Jayasree;Avila, Rosa;Ricciardi, Richard
研究目标。本研究考察了再入院率的小区域差异，以评估一个地区较高的再入院率是否与多种慢性疾病患者的高聚集性相关。研究设计。该研究使用了2009年美国6个州成人（18岁以上）患者的出院数据，这些数据来自医疗保健研究和质量机构的医疗保健成本和利用项目，并与卫生资源和服务管理局的背景和提供者数据相关联。在初级保健服务区域（PCSA）水平上采用多变量横断面设计。主要的发现。调整区域特征后，与0-1慢性疾病患者浓度较高的区域相比，2-3慢性疾病患者比例较高和4+慢性疾病患者比例较高的pcsa再入院率显著高于0-1慢性疾病患者比例较高的区域。通过小区域分析，该研究表明，合并症患者越集中的地区，再入院率越高。
Research Objective. This study examines small area variations in readmission rates to assess whether higher readmission rate in an area is associated with higher clusters of patients with multiple chronic conditions.Study Design. The study uses hospital discharge data of adult (18+) patients in 6 U.S. states for 2009 from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality, linked to contextual and provider data from Health Resources and Services Administration. A multivariate cross sectional design at primary care service area (PCSA) level is used.Principal Findings. Adjusting for area characteristics, the readmission rates were significantly higher in PCSAs having higher proportions of patients with 2-3 chronic conditions and those with 4+ chronic conditions, compared with areas with a higher concentration of patients with 0-1 chronic conditions.Conclusions. Using small area analysis, the study shows that areas with higher concentration of patients with increased comorbid conditions are more likely to have higher readmission rates.