ObjectiveRepeated hospitalisation for patients is common and costly, yet partly preventable. However, we know little about readmissions for patients with diabetes in China. The current study aims to assess the frequency and temporal pattern of and risk factors for all-cause readmission among hospitalised patients with diabetes in Tianjin, China.MethodThis retrospective, cohort analysis used the Tianjin Basic Medical Insurance Register System data of 2011. The patterns of and the reasons for all-cause readmissions for patients with diabetes were described. The differences of readmission-free survival (RFS) between newly and previously diagnosed patients were compared. Time-dependent Cox models were established to identify the risk factors for readmission at different time intervals after discharge.ResultsReadmission rates were approximately 30%, with the most common diagnoses of cerebral infarction (for type I) or diabetes (for type II) for patients with diabetes. The majority of patients were readmitted to the hospital after more than 90 days, followed by 8–30 days (all p=0.002). Approximately 37.2% and 42.8% of readmitted patients with type I and type II diabetes were diagnosed previously, and the RFS rates for previously diagnosed patients were significantly lower than for newly diagnosed patients at any time interval after discharge. Prior history of diabetes (all p<0.05), length of stay (all p<0.01) and reimbursement ratio (90% vs >92%, all p<0.0002) were consistently associated with the RFS for patients readmitted to the hospital at <7, 8–30, 31–60 and 61–90 days.ConclusionsHospital readmissions among patients with diabetes were affected by the diagnosis status. Patient characteristics and the quality of healthcare might regulate short-interval and long-interval hospital readmission, respectively, after discharge.
Structure optimization of Hardness Testing Device (HTD) based on virtual design is proposed here. The purpose of the HTD is to obtain hardness properties of accessories. Since the creation of the previous HTD, a few problems have been experienced during testing. In the present work, improvements in both equipment design and automation control have been made. A realistic digital analysis is generated by combining automated and interactive approaches to evaluate the capability of the device with simulation software ADAMS and AMESim. Theoretical analysis is taken into account to obtain numerical results close to reality. The approach and the conclusions should be useful for composite structures design. The improved design of HTD reduces the number of costly physical prototypes, improves design quality and reduces product development time.
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