Characteristics and temporal pattern of the readmissions of patients with multiple hospital admissions in the medical departments of a general hospital

Matesanz-Fernández, María; Monte-Secades, Rafael; Íñiguez-Vázquez, Iria; Rubal-Bran, D.; Guerrero-Sande, Héctor; Casariego-Vales, Emilio

doi:10.1016/j.ejim.2015.09.020

Cited by 17 publications

(7 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Bibliographies of the CPRD, the Boston Collaborative Drug Surveillance Programme, and The Health Improvement Network (THIN) were hand‐searched to identify additional relevant articles. The bibliographies of systematic reviews of the validity of multiple diagnoses contained within UK EHR databases, identified both through consultation with subject matter experts and through the search strategy, were screened for potentially relevant articles.…”

Section: Methodsmentioning

confidence: 99%

The validity of dementia diagnoses in routinely collected electronic health records in the United Kingdom: A systematic review

McGuinness

Warren‐Gash

Moorhouse

et al. 2019

Pharmacoepidemiology and Drug

View full text Add to dashboard Cite

Purpose The purpose of the study is to assess the validity of codes or algorithms used to identify dementia in UK electronic health record (EHR) primary care and hospitalisation databases. Methods Relevant studies were identified by searching the MEDLINE/EMBASE databases from inception to June 2018, hand‐searching reference lists, and consulting experts. The search strategy included synonyms for “Dementia”, “Europe”, and “EHR”. Studies were included if they validated dementia diagnoses in UK primary care or hospitalisation databases, irrespective of validation method used. The Quality Assessment for Diagnostic Accuracy Studies‐2 (QUADAS‐2) tool was used to assess risk of bias. Results From 1469 unique records, 14 relevant studies were included. Thirteen validated individual diagnoses against a reference standard, reporting high estimates of validity. Most reported only the positive predictive value (PPV), with estimates ranging between 0.09 and 1.0 and 0.62 and 0.85 in primary care and hospitalisation databases, respectively. One study performed a rate comparison, indicating good generalisability of dementia diagnoses in The Health Improvement Network (THIN) database to the UK population. Studies were of low methodological quality. As studies were not comparable, no summary validity estimates were produced. Conclusion While heterogenous across studies, reported validity estimates were generally high. However, the credibility of these estimates is limited by the methodological quality of studies, primarily resulting from insufficient blinding of researchers interpreting the reference test. Inadequate reporting, particularly of the specific codes validated, hindered comparison of estimates across studies. Future validation studies should make use of more robust reference tests, follow established reporting guidelines, and calculate all measures of validity.

show abstract

Section: Methodsmentioning

confidence: 99%

The validity of dementia diagnoses in routinely collected electronic health records in the United Kingdom: A systematic review

McGuinness

Warren‐Gash

Moorhouse

et al. 2019

Pharmacoepidemiology and Drug

View full text Add to dashboard Cite

show abstract

“…Within this concept, the subgroup of multiple admissions for ACSC has been gaining a growing importance. Multiple admissions for ACSC are characterized by the frequent utilization of inpatient care for ACSC by the same patient within a period of time [9]. While readmission assessment is mainly focused on quality of inpatient and transitional care [10], the appraisal of multiple admissions allows the assessment of ambulatory care quality before and after discharge [9, 11].…”

Section: Introductionmentioning

confidence: 99%

The impact of diabetes on multiple avoidable admissions: a cross-sectional study

Seringa

Marques

Moita

et al. 2019

BMC Health Serv Res

View full text Add to dashboard Cite

BackgroundMultiple admissions for ambulatory care sensitive conditions (ACSC) are responsible for an important proportion of health care expenditures. Diabetes is one of the conditions consensually classified as an ACSC being considered a major public health concern. The aim of this study was to analyse the impact of diabetes on the occurrence of multiple admissions for ACSC.MethodsWe analysed inpatient data of all public Portuguese NHS hospitals from 2013 to 2015 on multiple admissions for ACSC among adults aged 18 or older. Multiple ACSC users were identified if they had two or more admissions for any ACSC during the period of analysis. Two logistic regression models were computed. A baseline model where a logistic regression was performed to assess the association between multiple admissions and the presence of diabetes, adjusting for age and sex. A full model to test if diabetes had no constant association with multiple admissions by any ACSC across age groups.ResultsAmong 301,334 ACSC admissions, 144,209 (47.9%) were classified as multiple admissions and from those, 59,436 had diabetes diagnosis, which corresponded to 23,692 patients. Patients with diabetes were 1.49 times (p < 0,001) more likely to be admitted multiple times for any ACSC than patients without diabetes. Younger adults with diabetes (18–39 years old) were more likely to become multiple users.ConclusionDiabetes increases the risk of multiple admissions for ACSC, especially in younger adults. Diabetes presence is associated with a higher resource utilization, which highlights the need for the implementation of adequate management of chronic diseases policies.

show abstract

“…In that related to frequency of use, 30-day readmission rates are widely referenced. The assessment of longer time intervals between hospitalisations, addressing the concept of patients with multiple admissions,13 27–29 may reveal patterns not apparent within 30 days after previous discharge30 and increase the probability that rehospitalisations captured are related to outpatient quality of care 31. Therefore it is apparently aligned with the premises of HF as ACSC.…”

Section: Introductionmentioning

confidence: 99%

One-year rehospitalisations for congestive heart failure in Portuguese NHS hospitals: a multilevel approach on patterns of use and contributing factors

et al. 2019

View full text Add to dashboard Cite

ObjectivesIdentification of rehospitalisations for heart failure and contributing factors flags health policy intervention opportunities designed to deliver care at a most effective and efficient level. Recognising that heart failure is a condition for which timely and appropriate outpatient care can potentially prevent the use of inpatient services, we aimed to determine to what extent comorbidities and material deprivation were predictive of 1 year heart failure specific rehospitalisation.SettingAll Portuguese mainland National Health Service (NHS) hospitals.ParticipantsA total of 68 565 hospitalisations for heart failure principal cause of admission, from 2011 to 2015, associated to 45 882 distinct patients aged 18 years old or over.Outcome measuresWe defined 1 year specific heart failure rehospitalisation and time to rehospitalisation as outcome measures.ResultsHeart failure principal diagnosis admissions accounted for 1.6% of total hospital NHS budget, and over 40% of this burden is associated to patients rehospitalised at least once in the 365-day follow-up period. 22.1% of the patients hospitalised for a principal diagnosis of heart failure were rehospitalised for the same cause at least once within 365 days after previous discharge. Nearly 55% of rehospitalised patients were readmitted within 3 months. Results suggest a mediation effect between material deprivation and the chance of 1 year rehospitalisation through the effect that material deprivation has on the prevalence of comorbidities. Heart failure combined with chronic kidney disease or chronic obstructive pulmonary disease increases by 2.8 and 2.2 times, respectively, the chance of the patient becoming a frequent user of inpatient services for heart failure principal cause of admission.ConclusionsOne-fifth of patients admitted for heart failure are rehospitalised due to heart failure exacerbation. While the role of material deprivation remained unclear, comorbidities considered increased the chance of 1 year heart failure specific rehospitalisation, in particular, chronic kidney disease and chronic obstructive pulmonary disease.

show abstract

Characteristics and temporal pattern of the readmissions of patients with multiple hospital admissions in the medical departments of a general hospital

Cited by 17 publications

References 20 publications

The validity of dementia diagnoses in routinely collected electronic health records in the United Kingdom: A systematic review

The validity of dementia diagnoses in routinely collected electronic health records in the United Kingdom: A systematic review

The impact of diabetes on multiple avoidable admissions: a cross-sectional study

One-year rehospitalisations for congestive heart failure in Portuguese NHS hospitals: a multilevel approach on patterns of use and contributing factors

Contact Info

Product

Resources

About