sábado, 11 de agosto de 2012

Gender as risk factor for 30 days post-discharge ho... [BMJ Open. 2012] - PubMed - NCBI

Gender as risk factor for 30 days post-discharge ho... [BMJ Open. 2012] - PubMed - NCBI

BMJ Open. 2012 Apr 18;2(2):e000428. Print 2012.

Gender as risk factor for 30 days post-discharge hospital utilisation: a secondary data analysis.

Source

Department of Family Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.

Abstract

OBJECTIVE:

In the 30 days after hospital discharge, hospital utilisation is common and costly. This study evaluated the association between gender and hospital utilisation within 30 days of discharge.

DESIGN:

Secondary data analysis using Poisson regression stratified by gender.

PARTICIPANTS:

737 English-speaking hospitalised adults from general medical service in urban, academic safety-net medical centre who participated in the Project Re-Engineered clinical trial (clinicaltrials.gov identifier: NCT00252057).

MAIN OUTCOME MEASURE:

The primary end point was hospital utilisation, defined as total emergency department visits and hospital readmissions within 30 days after index discharge.

RESULTS:

Female subjects had a rate of 29 events for every 100 people and male subjects had a rate of 47 events for every 100 people (incident rate ratio (IRR) 1.62, 95% CI 1.28 to 2.06). Among men, risk factors included hospital utilisation in the 6 months prior to the index hospitalisation (IRR 3.55, 95% CI 2.38 to 5.29), being unmarried (IRR 1.72, 95% CI 1.12 to 2.64), having a positive depression screen (IRR 1.53, 95% CI 1.09 to 2.13) and no primary care physician (PCP) visit within 30 days (IRR 1.64, 95% CI 1.08 to 2.50). Among women, the only risk factor was hospital utilisation in the 6 months prior to the index hospitalisation (IRR 3.08, 95% CI 1.86 to 5.10).

CONCLUSIONS:

In our data, male subjects had a higher rate of hospital utilisation within 30 days of discharge than female subjects. For men-but not for women-risk factors were being retired, unmarried, having depressive symptoms and having no PCP visit within 30 days. Interventions addressing these factors might lower hospital utilisation rates observed among men.

PMID:
22514241
[PubMed - in process]
PMCID:
PMC3332240
Free PMC Article

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