Hospital Readmissions in Portugal over the Last Decade

Detalhes bibliográficos
Autor(a) principal: Sousa-Pinto, Bernardo
Data de Publicação: 2013
Outros Autores: Gomes, Ana Rita, Oliveira, Andreia, Ivo, Carlos, Costa, Gustavo, Ramos, João, Silva, Joel, Carneiro, Maria Carolina, Domingues, Maria João, Cunha, Maria João, Costa-Pereira, Altamiro da, Freitas, Alberto
Tipo de documento: Artigo
Idioma: por
eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2178
Resumo: Introduction: Hospital readmissions are associated with increased healthcare expenses and with higher hospital fatality rates. We aim to characterize unplanned hospital readmissions occurred within 30 days after discharge, according to its Major Diagnosis Category, hospital type and location, and patients’ demographic attributes. We also intend to estimate the hospital fatality rates associated to those readmissions, as well as to study the evolution of hospital readmissions rates in the last decade (2000-2008). Moreover, we aim to characterize heart failure readmissions.Material and Methods: We analysed a database (provided by Autoridade Central do Sistema de Saúde) containing all hospital admissions occurred in Portuguese public hospitals. In order to compare readmissions rates, we performed chi-square tests and linear-bylinear association tests.Results: Between 2000 and 2008, there were 5 514 331 unplanned admissions, of which 4.1% corresponded to hospital readmissions, classified with the same Major Diagnosis Category of the first admission. Between 2000 and 2008, hospital readmissions rate increased continuously from 3.0% to 4.7%. Hospital fatality rate was significantly higher among readmitted cases (9.5 versus 5.6%, p < 0.001). Readmissions rates were also significantly higher among episodes involving older patients (2.6% in children versus 5.3% in the elderly) and males (4.5% versus 3.9% in females, p < 0.001), being lower in Lisbon region (2.7%) and in central hospitals (3.0%, p < 0.001). For episodes of heart failure, we found a readmissions rate of 6.7%.Discussion and Conclusion: Most of the differences found are consistent with those described in other Western countries. Readmission episodes, whose rates have been increasing in Portugal, are associated with higher hospital fatality rates.
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spelling Hospital Readmissions in Portugal over the Last DecadeReinternamentos Hospitalares em Portugal na Última DécadaIntroduction: Hospital readmissions are associated with increased healthcare expenses and with higher hospital fatality rates. We aim to characterize unplanned hospital readmissions occurred within 30 days after discharge, according to its Major Diagnosis Category, hospital type and location, and patients’ demographic attributes. We also intend to estimate the hospital fatality rates associated to those readmissions, as well as to study the evolution of hospital readmissions rates in the last decade (2000-2008). Moreover, we aim to characterize heart failure readmissions.Material and Methods: We analysed a database (provided by Autoridade Central do Sistema de Saúde) containing all hospital admissions occurred in Portuguese public hospitals. In order to compare readmissions rates, we performed chi-square tests and linear-bylinear association tests.Results: Between 2000 and 2008, there were 5 514 331 unplanned admissions, of which 4.1% corresponded to hospital readmissions, classified with the same Major Diagnosis Category of the first admission. Between 2000 and 2008, hospital readmissions rate increased continuously from 3.0% to 4.7%. Hospital fatality rate was significantly higher among readmitted cases (9.5 versus 5.6%, p < 0.001). Readmissions rates were also significantly higher among episodes involving older patients (2.6% in children versus 5.3% in the elderly) and males (4.5% versus 3.9% in females, p < 0.001), being lower in Lisbon region (2.7%) and in central hospitals (3.0%, p < 0.001). For episodes of heart failure, we found a readmissions rate of 6.7%.Discussion and Conclusion: Most of the differences found are consistent with those described in other Western countries. Readmission episodes, whose rates have been increasing in Portugal, are associated with higher hospital fatality rates.Introdução: Os reinternamentos hospitalares estão associados a um incremento das despesas com a saúde e da mortalidade intrahospitalar. Neste trabalho, pretende-se caracterizar os reinternamentos hospitalares não-planeados, ocorridos num período de 30 dias após alta, de acordo com a sua Grande Categoria Diagnóstica, contexto hospitalar e características demográficas dos utentes, bem como estimar as taxas de mortalidade associadas. Pretende-se também estudar a evolução da taxa de reinternamentos na última década (2000-2008). Procurar-se-á ainda caracterizar os reinternamentos por insuficiência cardíaca.Material e Métodos: Procedeu-se à análise estatística da base de dados de internamentos hospitalares públicos fornecida pelaAutoridade Central do Sistema de Saúde. Recorreu-se aos testes do qui-quadrado e de tendência para comparação de taxas dereinternamentos.Resultados: Das 5 514 331 hospitalizações não-planeadas no período em estudo, 4,1% corresponderam a reinternamentos hospitalares. Entre 2000 e 2008, a taxa de reinternamentos hospitalares aumentou continuamente de 3,0% para 4,7%. A mortalidade hospitalar foi significativamente maior entre os episódios de reinternamento (9,5%) do que nos restantes episódios (5,6%), p < 0,001. A taxa de reinternamentos foi significativamente maior em homens (4,5% versus 3,9% nas mulheres, p < 0,001) e doentes mais velhos (2,6% nas crianças e 5,3% nos idosos), sendo menor na região de Lisboa (2,7%) e nos hospitais centrais (3,0%, p < 0,001). Para os episódios de insuficiência cardíaca, foi obtida uma taxa de reinternamentos de 6,7%.Discussão e Conclusão: Em termos gerais, as diferenças encontradas são similares às descritas noutros Países Ocidentais. Os episódios de reinternamento, cujas taxas têm vindo a aumentar em Portugal, estão associados a maior mortalidade intra-hospitalar.Ordem dos Médicos2013-12-20info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2178oai:ojs.www.actamedicaportuguesa.com:article/2178Acta Médica Portuguesa; Vol. 26 No. 6 (2013): November-December; 711-720Acta Médica Portuguesa; Vol. 26 N.º 6 (2013): Novembro-Dezembro; 711-7201646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2178https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2178/3813https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2178/3913Sousa-Pinto, BernardoGomes, Ana RitaOliveira, AndreiaIvo, CarlosCosta, GustavoRamos, JoãoSilva, JoelCarneiro, Maria CarolinaDomingues, Maria JoãoCunha, Maria JoãoCosta-Pereira, Altamiro daFreitas, Albertoinfo:eu-repo/semantics/openAccess2022-12-20T10:59:57Zoai:ojs.www.actamedicaportuguesa.com:article/2178Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:17:34.733342Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Hospital Readmissions in Portugal over the Last Decade
Reinternamentos Hospitalares em Portugal na Última Década
title Hospital Readmissions in Portugal over the Last Decade
spellingShingle Hospital Readmissions in Portugal over the Last Decade
Sousa-Pinto, Bernardo
title_short Hospital Readmissions in Portugal over the Last Decade
title_full Hospital Readmissions in Portugal over the Last Decade
title_fullStr Hospital Readmissions in Portugal over the Last Decade
title_full_unstemmed Hospital Readmissions in Portugal over the Last Decade
title_sort Hospital Readmissions in Portugal over the Last Decade
author Sousa-Pinto, Bernardo
author_facet Sousa-Pinto, Bernardo
Gomes, Ana Rita
Oliveira, Andreia
Ivo, Carlos
Costa, Gustavo
Ramos, João
Silva, Joel
Carneiro, Maria Carolina
Domingues, Maria João
Cunha, Maria João
Costa-Pereira, Altamiro da
Freitas, Alberto
author_role author
author2 Gomes, Ana Rita
Oliveira, Andreia
Ivo, Carlos
Costa, Gustavo
Ramos, João
Silva, Joel
Carneiro, Maria Carolina
Domingues, Maria João
Cunha, Maria João
Costa-Pereira, Altamiro da
Freitas, Alberto
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Sousa-Pinto, Bernardo
Gomes, Ana Rita
Oliveira, Andreia
Ivo, Carlos
Costa, Gustavo
Ramos, João
Silva, Joel
Carneiro, Maria Carolina
Domingues, Maria João
Cunha, Maria João
Costa-Pereira, Altamiro da
Freitas, Alberto
description Introduction: Hospital readmissions are associated with increased healthcare expenses and with higher hospital fatality rates. We aim to characterize unplanned hospital readmissions occurred within 30 days after discharge, according to its Major Diagnosis Category, hospital type and location, and patients’ demographic attributes. We also intend to estimate the hospital fatality rates associated to those readmissions, as well as to study the evolution of hospital readmissions rates in the last decade (2000-2008). Moreover, we aim to characterize heart failure readmissions.Material and Methods: We analysed a database (provided by Autoridade Central do Sistema de Saúde) containing all hospital admissions occurred in Portuguese public hospitals. In order to compare readmissions rates, we performed chi-square tests and linear-bylinear association tests.Results: Between 2000 and 2008, there were 5 514 331 unplanned admissions, of which 4.1% corresponded to hospital readmissions, classified with the same Major Diagnosis Category of the first admission. Between 2000 and 2008, hospital readmissions rate increased continuously from 3.0% to 4.7%. Hospital fatality rate was significantly higher among readmitted cases (9.5 versus 5.6%, p < 0.001). Readmissions rates were also significantly higher among episodes involving older patients (2.6% in children versus 5.3% in the elderly) and males (4.5% versus 3.9% in females, p < 0.001), being lower in Lisbon region (2.7%) and in central hospitals (3.0%, p < 0.001). For episodes of heart failure, we found a readmissions rate of 6.7%.Discussion and Conclusion: Most of the differences found are consistent with those described in other Western countries. Readmission episodes, whose rates have been increasing in Portugal, are associated with higher hospital fatality rates.
publishDate 2013
dc.date.none.fl_str_mv 2013-12-20
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publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 26 No. 6 (2013): November-December; 711-720
Acta Médica Portuguesa; Vol. 26 N.º 6 (2013): Novembro-Dezembro; 711-720
1646-0758
0870-399X
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