Local health units in Portugal
Autor(a) principal: | |
---|---|
Data de Publicação: | 2019 |
Outros Autores: | , , , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10362/96543 |
Resumo: | Background: In Portugal, a public policy established the Local Health Units (LHUs), merging primary and hospital care providers. LHUs are expected to provide better continuity and coordination of care, thus decreasing the number of unplanned readmissions among those with chronic conditions. This study aims to evaluate the influence of chronic conditions on the risk of readmission at LHUs. Methods: We used inpatient care administrative databases for the years 2002-2014 (n = 1,679,634). We assessed the effects of chronic conditions on the risk of readmission with a difference-in-differences technique, comparing LHUs with a control group. Multivariate Cox regression was used to evaluate time to readmission. Results: The risk of readmission decreased in four LHUs, but significantly only in two. Individuals with more chronic conditions presented a lesser risk of read-mission at LHUs, in contrast to those in the control group. Conclusions: After adjusting for the number of chronic conditions and comorbidities, we concluded that LHUs may successfully decrease unplanned readmissions. Several challenges still have to be addressed to achieve a larger and long-lasting effect. Further investigation is needed to account for contextual and organizational effects that may explain differences across LHUs. |
id |
RCAP_76998eb5a680dda21149518193c0d20b |
---|---|
oai_identifier_str |
oai:run.unl.pt:10362/96543 |
network_acronym_str |
RCAP |
network_name_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository_id_str |
7160 |
spelling |
Local health units in PortugalUnidades Locais de Saúde em Portugala influência das condições crónicas nas readmissõesthe influence of chronic conditions on inpatient readmissionsBackground: In Portugal, a public policy established the Local Health Units (LHUs), merging primary and hospital care providers. LHUs are expected to provide better continuity and coordination of care, thus decreasing the number of unplanned readmissions among those with chronic conditions. This study aims to evaluate the influence of chronic conditions on the risk of readmission at LHUs. Methods: We used inpatient care administrative databases for the years 2002-2014 (n = 1,679,634). We assessed the effects of chronic conditions on the risk of readmission with a difference-in-differences technique, comparing LHUs with a control group. Multivariate Cox regression was used to evaluate time to readmission. Results: The risk of readmission decreased in four LHUs, but significantly only in two. Individuals with more chronic conditions presented a lesser risk of read-mission at LHUs, in contrast to those in the control group. Conclusions: After adjusting for the number of chronic conditions and comorbidities, we concluded that LHUs may successfully decrease unplanned readmissions. Several challenges still have to be addressed to achieve a larger and long-lasting effect. Further investigation is needed to account for contextual and organizational effects that may explain differences across LHUs.Centro de Investigação em Saúde Pública (CISP/PHRC)Escola Nacional de Saúde Pública (ENSP)RUNFernandes, Óscar Ricardo BritoLopes, SílviaMarques, Ana PatríciaMoita, Bruno DominguesSarmento, João Carlos CordeiroSantana, Rui2020-04-20T22:34:00Z20192019-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/965432504-3137PURE: 17842399https://doi.org/DOI: 10.1159/000506015info:eu-repo/semantics/openAccessporreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T04:44:10Zoai:run.unl.pt:10362/96543Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:38:36.201710Repositório 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 |
Local health units in Portugal Unidades Locais de Saúde em Portugala influência das condições crónicas nas readmissões the influence of chronic conditions on inpatient readmissions |
title |
Local health units in Portugal |
spellingShingle |
Local health units in Portugal Fernandes, Óscar Ricardo Brito |
title_short |
Local health units in Portugal |
title_full |
Local health units in Portugal |
title_fullStr |
Local health units in Portugal |
title_full_unstemmed |
Local health units in Portugal |
title_sort |
Local health units in Portugal |
author |
Fernandes, Óscar Ricardo Brito |
author_facet |
Fernandes, Óscar Ricardo Brito Lopes, Sílvia Marques, Ana Patrícia Moita, Bruno Domingues Sarmento, João Carlos Cordeiro Santana, Rui |
author_role |
author |
author2 |
Lopes, Sílvia Marques, Ana Patrícia Moita, Bruno Domingues Sarmento, João Carlos Cordeiro Santana, Rui |
author2_role |
author author author author author |
dc.contributor.none.fl_str_mv |
Centro de Investigação em Saúde Pública (CISP/PHRC) Escola Nacional de Saúde Pública (ENSP) RUN |
dc.contributor.author.fl_str_mv |
Fernandes, Óscar Ricardo Brito Lopes, Sílvia Marques, Ana Patrícia Moita, Bruno Domingues Sarmento, João Carlos Cordeiro Santana, Rui |
description |
Background: In Portugal, a public policy established the Local Health Units (LHUs), merging primary and hospital care providers. LHUs are expected to provide better continuity and coordination of care, thus decreasing the number of unplanned readmissions among those with chronic conditions. This study aims to evaluate the influence of chronic conditions on the risk of readmission at LHUs. Methods: We used inpatient care administrative databases for the years 2002-2014 (n = 1,679,634). We assessed the effects of chronic conditions on the risk of readmission with a difference-in-differences technique, comparing LHUs with a control group. Multivariate Cox regression was used to evaluate time to readmission. Results: The risk of readmission decreased in four LHUs, but significantly only in two. Individuals with more chronic conditions presented a lesser risk of read-mission at LHUs, in contrast to those in the control group. Conclusions: After adjusting for the number of chronic conditions and comorbidities, we concluded that LHUs may successfully decrease unplanned readmissions. Several challenges still have to be addressed to achieve a larger and long-lasting effect. Further investigation is needed to account for contextual and organizational effects that may explain differences across LHUs. |
publishDate |
2019 |
dc.date.none.fl_str_mv |
2019 2019-01-01T00:00:00Z 2020-04-20T22:34:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10362/96543 |
url |
http://hdl.handle.net/10362/96543 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
2504-3137 PURE: 17842399 https://doi.org/DOI: 10.1159/000506015 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.source.none.fl_str_mv |
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
_version_ |
1799138002164776960 |