A prospective cohort study of healthcare visits and rehospitalizations after discharge of patients with community‐acquired pneumonia

Adamuz, Jordi; Viasus, Diego; Campreciós-Rodríguez, Paula; Cañavate-Jurado, Olga; Jiménez-Martínez, Emilio; Isla, Pablo; García-Vidal, Carolina; Carratalà, Jordi

doi:10.1111/j.1440-1843.2011.02017.x

Cited by 29 publications

(50 citation statements)

References 28 publications

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“…In other studies investigating healthcare reconsultation following a diagnosis of CAP, reasons for reconsultation were investigator assigned and, therefore, classification of reasons for healthcare utilisation were less specific than that reported by our study. 6,13 Regardless, in keeping with our data, respiratory symptoms were the most frequently observed symptoms, and accounted for 75% of visits to primary care physicians.…”

Section: Summary Of Resultssupporting

confidence: 61%

“…In a single-centre study conducted in Spain, Adamuz et al reported that 34% of patients discharged with CAP had an episode of healthcare reconsultation within 30 days of discharge. 13 In contrast to our study, most of these episodes were A&E visits (63%) with GP visits only representing over 52.8% of healthcare reconsultation episodes. A Dutch study using coding-derived data showed an even smaller proportion of patients (8%) requiring GP consultations in the month following discharge from hospital.…”

Section: Comparison With Existing Literaturecontrasting

confidence: 45%

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Healthcare reconsultation in working-age adults following hospitalisation for community-acquired pneumonia

Daniel

Bewick²,

McKeever

et al. 2018

Clinical Medicine

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Community-acquired pneumonia (CAP) is associated with prolonged symptom persistence during recovery. However, the effect of the residual symptom load on healthcare utilisation is unknown. The aim of this study was to quantify healthcare reconsultation within 28 days of hospital discharge for an index episode of CAP, and explore reasons for these reconsultations. Adults of working age admitted to any of four hospitals in the UK, with a primary diagnosis of CAP, were prospectively studied. Of 108 patients, 71 (65.7%) reconsulted healthcare services within 28 days of discharge; of these, 90.1% consulted their GP. Men were less likely to reconsult than women (adjusted odds ratio [aOR] 0.34, 95% confidence interval 0.13-0.91, p=0.032). Persistence of respiratory symptoms accounted for the majority of these reconsultations. Healthcare utilisation is high in working-age adults after an episode of hospitalised CAP and, in most cases, is due to failure to resolve index symptoms.

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Section: Summary Of Resultssupporting

confidence: 61%

Section: Comparison With Existing Literaturecontrasting

confidence: 45%

Healthcare reconsultation in working-age adults following hospitalisation for community-acquired pneumonia

Daniel

Bewick²,

McKeever

et al. 2018

Clinical Medicine

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“…Studies varied in their approach to identifying index hospitalizations (Table E2). Five used prospective clinical assessment (22)(23)(24)(25)(26), two used retrospective clinical assessment (27,28), and five relied on administrative claims data (29)(30)(31)(32)(33). Studies using clinical assessment often required (1) a clinical presentation consistent with pneumonia, and (2) radiologic evidence of an infiltrate.…”

Section: Methodology Of Included Studiesmentioning

confidence: 99%

“…Studies varied in their approach to defining the cause of readmission. Five studies used retrospective clinical assessment (23,(25)(26)(27), and seven studies used administrative data (12,13,(29)(30)(31) (Table E3). …”

Section: Methodology Of Included Studiesmentioning

confidence: 99%

Diagnoses of Early and Late Readmissions after Hospitalization for Pneumonia. A Systematic Review

2014

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Rationale: Pneumonia is a frequent cause of hospitalization, yet drivers of post-pneumonia morbidity remain poorly characterized. Causes of hospital readmissions may elucidate important sources of morbidity and are of particular interest given the U.S. Hospital Readmission Reductions Program.Objectives: To review the primary diagnoses of early (<30 d) and late (>31 d) readmissions after pneumonia hospitalization.Methods: Systematic review of MEDLINE, Embase, and CINAHL databases. We identified original research studies of adults aged 18 years or older, hospitalized for pneumonia, and for whom cause-specific readmission rates were reported. Two authors abstracted study results and assessed study quality. Measurements and Main Results:Of the 1,243 citations identified, 12 met eligibility criteria. Included studies were conducted in the United States, Spain, Canada, Croatia, and Sweden. All-cause 30-day readmission rates ranged from 16.8 to 20.1% across administrative studies; the weighted average for the studies using chart review was 11.6% (15.6% in United Statesbased studies). Pneumonia, heart failure/cardiovascular causes, and chronic obstructive pulmonary disease/pulmonary causes are the most common reasons for early readmission after pneumonia hospitalization. Although it was the single most common cause for readmission, pneumonia accounted for only 17.9 to 29.4% of all 30-day readmissions in administrative studies and a weighted average of 23.0% in chart review studies. After accounting for study population, there was no clear difference in findings between claims-based versus chart-review studies. Few studies assessed readmissions beyond 30 days, although the limited available data suggest similar primary diagnoses for early and late readmissions. No studies assessed whether reasons for readmission were similar to patients' reasons for healthcare use before hospitalization.Conclusions: Pneumonia, heart failure/cardiovascular disease, and chronic obstructive pulmonary disease/pulmonary disease are the most common readmission diagnoses after pneumonia hospitalization. Although pneumonia was the most common readmission diagnosis, it accounted for only a minority of all readmissions. Late readmission diagnoses are less thoroughly described, and further research is needed to understand how hospitalization for pneumonia fits within the broader context of patients' health trajectory.

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“…En varios trabajos se ha señalado un mayor número de hombres readmitidos, tanto en estudios generales de reingresos 2,28 como en trabajos de patologías específi-cas, tales como neumonía, enfermedad pulmonar obstructiva crónica y fallo cardíaco 12,24,34,35 , pero en otros estudios el sexo no parece relacionarse con el reingreso 32 . Se requieren estudios adicionales que permitan clarificar el papel del sexo como factor de riesgo para reingreso, y los posibles factores relacionados.…”

Section: Sexounclassified

Frecuencia de reingresos hospitalarios y factores asociados en afiliados a una administradora de servicios de salud en Colombia

et al. 2016

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Resumen: Los reingresos hospitalarios son frecuentes y costosos, en Colombia existe poca información. El objetivo fue establecer la frecuencia de reingresos hospitalarios por cualquier causa a 30 días y factores asociados. Se trata de un estudio analítico con cohorte retrospectiva 64.969 hospitalizaciones entre enero de 2008 y enero de 2009 en 47 ciudades colombianas 6.573 reingresos hospitalarios, prevalencia: 10,1% (hombres 10,9%; mujeres 9,5%), 44,7% en > 65 años. Mortalidad mayor en reingresos hospitalarios (5,8% vs. 1,8%). Mayor carga de reingresos hospitalarios en grupo sistema circulatorio. Mayor probabilidad de reingresos hospitalarios en enfermedades hematológicas y neoplasias. Estancia hospitalaria promedio durante el primer ingreso: 7 días en pacientes que reingresaron y 4,5 en quienes no. Costo total mayor para reingresos hospitalarios (USD 21.998.275): 15,8% del costo total de hospitalizaciones. Mayor prevalencia en pacientes remitidos (18,8%) y de consulta externa (13,7%). Los reingresos hospitalarios son frecuentes, se asocian con mayor estancia, mortalidad y costo. Mayor riesgo de reingresos hospitalarios en sexo masculino, > 65 años, pacientes remitidos de otra institución, enfermedades hematológicas y neoplasias.

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A prospective cohort study of healthcare visits and rehospitalizations after discharge of patients with community‐acquired pneumonia

Cited by 29 publications

References 28 publications

Healthcare reconsultation in working-age adults following hospitalisation for community-acquired pneumonia

Healthcare reconsultation in working-age adults following hospitalisation for community-acquired pneumonia

Diagnoses of Early and Late Readmissions after Hospitalization for Pneumonia. A Systematic Review

Frecuencia de reingresos hospitalarios y factores asociados en afiliados a una administradora de servicios de salud en Colombia

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