Prevalence and temporal pattern of hospital readmissions for patients with type I and type II diabetes

Liu, Xiaoqian; Liu, Yuanyuan; Lv, Yuanjun; Li, Changping; Cui, Zhuang; Ma, Jun

doi:10.1136/bmjopen-2014-007362

Cited by 12 publications

(5 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…After the large financial input cut, China’s public hospitals were permitted to retain surplus from drug or services sales [ 30 , 31 ]. In China prescription drugs are predominantly distributed and sold in hospitals, which accounts for over 70% of all drugs sold and distributed [ 32 ], as well, the hospitals are allowed to mark-up drug price (usually 15% margin on drugs) [ 28 ] to gain profit for operating costs and retaining surplus. Hospitals pay bonuses to their chief executive officers (CEOs) as well as physicians using the retained surplus.…”

Section: Methodsmentioning

confidence: 99%

The effects of patient cost sharing on inpatient utilization, cost, and outcome

et al. 2017

PLoS ONE

View full text Add to dashboard Cite

BackgroundHealth insurance and provider payment reforms all over the world beg a key empirical question: what are the potential impacts of patient cost-sharing on health care utilization, cost and outcomes? The unique health insurance system and rich electronic medical record (EMR) data in China provides us a unique opportunity to study this topic.MethodsFour years (2010 to 2014) of EMR data from one medical center in China were utilized, including 10,858 adult patients with liver diseases. We measured patient cost-sharing using actual reimbursement ratio (RR) which is allowed us to better capture financial incentive than using type of health insurance. A rigorous risk adjustment method was employed with both comorbidities and disease severity measures acting as risk adjustors. Associations between RR and health use, costs and outcome were analyzed by multivariate analyses.ResultsAfter risk adjustment, patients with more generous health insurance coverage (higher RR) were found to have longer hospital stay, higher total cost, higher medication cost, and higher ratio of medication to total cost, as well as higher number and likelihood that specific procedures were performed.ConclusionOur study implied that patient cost-sharing affects health care services use and cost. This reflects how patients and physicians respond to financial incentives in the current healthcare system in China, and the responses could be a joint effect of both demand and supply side moral hazard. In order to contain cost and improve efficiency in the system, reforming provide payment and insurance scheme is urgently needed.

show abstract

Section: Methodsmentioning

confidence: 99%

The effects of patient cost sharing on inpatient utilization, cost, and outcome

et al. 2017

PLoS ONE

View full text Add to dashboard Cite

show abstract

“…Investigation about the profile of and prevalence of search for healthcare services by individuals with diabetes showed a lower prevalence in patients with a longer period since the diagnosis, such as the elderly. 29 The aged with diabetes can present with better self-care due to the greater knowledge of the disease and treatment, owing to the diagnosis made years before, and explaining the protective factor found for search for emergency services. Better care of one’s health, especially by women, explains the association with chronic renal disease.…”

Section: Discussionmentioning

confidence: 99%

“…Investigação sobre o perfil e a prevalência de procura de serviços de saúde por indivíduos com diabetes mostrou menor prevalência em pacientes com tempo mais longo de diagnóstico da doença, como os idosos. 29 Os idosos com diabetes podem apresentar melhor autocuidado em função do maior conhecimento da doença e do tratamento, em virtude do diagnóstico realizado há vários anos, explicando o fator de proteção encontrado para busca por serviços de emergência. O melhor cuidado para saúde e, especialmente, pelas mulheres explica a associação com doença renal crônica.…”

Section: Discussionunclassified

Emergency department visits of older adults within 30 days of discharge: analysis from the pharmacotherapy perspective

Santos¹,

Dias²,

Reis³

2019

Einstein (São Paulo)

View full text Add to dashboard Cite

Objective To analyze, from the pharmacotherapy perspective, the factors associated to visits of older adults to the emergency department within 30 days after discharge.Methods A cross-sectional study carried out in a general public hospital with older adults. Emergency department visit was defined as the stay of the older adult in this service for up to 24 hours. The complexity of drug therapy was determined using the Medication Regimen Complexity Index. Potentially inappropriate drugs for use in older adults were classified according to the American Geriatric Society/Beers criteria of 2015. The outcome investigated was the frequency of visits to the emergency department within 30 days of discharge. Multivariate logistic regression was performed to identify the factors associated with the emergency department visit.Results A total of 255 elderly in the study, and 67 (26.3%) visited emergency department within 30 days of discharge. Polypharmacy and potentially inappropriate medications for older adults did not present a statistically significant association. The diagnosis of heart failure and Medication Regimen Complexity Index >16.5 were positively associated with emergency department visits (OR=2.3; 95%CI: 1.04-4.94; p=0.048; and OR=2.1; 95%CI: 1.11-4.02; p=0.011), respectively. Furthermore, the diagnosis of diabetes mellitus and chronic kidney disease were protection factors for the outcome (OR=0.4; 95%CI: 0.20-0.73; p=0.004; and OR=0.3; 95%CI: 0.13-0.86; p=0.023).Conclusion The diagnosis of heart failure and Medication Regimen Complexity Index >16.5 were positively associated with the occurrence of an emergency department visit within 30 days of discharge.

show abstract

“…Studies that have used data from multiple visits of the same patients rather than only the most recent visit (Almagro et al, 2006;Daly, Douglas, Kelley, O'Toole, & Montenegro, 2005;Liu et al, 2015) have mostly not extended their analysis to measure predictive performance. The only study that we found that integrated information from many visits and also did predictive analytics did it specifically for Congestive Heart Failure (CHF) (Bardhan et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Analysing repeated hospital readmissions using data mining techniques

Ben‐Assuli

Padman

2018

Health Systems

View full text Add to dashboard Cite

Few studies have examined how to identify future readmission of patients with a large number of repeat emergency department (ED) visits. We explore 30-day readmission risk prediction using Microsoft's AZURE machine learning software and compare five classification methods: Logistic Regression, Boosted Decision Trees (BDTs), Support Vector Machine (SVM), Bayes Point Machine (BPM), and Two-Class Neural Network (TCNN). We predict the last readmission visit of frequent ED patients extracted from the electronic health records of their 8455 penultimate visits. The methods show differential improvement, with the BDT indicating marginally better AUC (area under the ROC curve) than logistic regression and BPM, followed by the TCNN and SVM. A comparison of BDT and Logistic Regression results for correct and incorrect classification highlights the similarities and differences in the significant predictors identified by each method. Future research may incorporate time-varying covariates to identify other longitudinal factors that can lead to readmission risk reduction. This article by Ofir Ben-Assuli and Rema Padman. (2018). Analysing repeated hospital readmissions using data mining techniques, was incorrectly published in issue 2. The article has been republished in this issue. Taylor and Francis apologise for this error.

show abstract

Prevalence and temporal pattern of hospital readmissions for patients with type I and type II diabetes

Cited by 12 publications

References 47 publications

The effects of patient cost sharing on inpatient utilization, cost, and outcome

The effects of patient cost sharing on inpatient utilization, cost, and outcome

Emergency department visits of older adults within 30 days of discharge: analysis from the pharmacotherapy perspective

Analysing repeated hospital readmissions using data mining techniques

Contact Info

Product

Resources

About