Hospital Readmissions in Portugal over the Last Decade
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , , , , , , , , |
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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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 |
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2013-12-20 |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2178 oai:ojs.www.actamedicaportuguesa.com:article/2178 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2178 |
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por eng |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2178 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2178/3813 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/2178/3913 |
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Ordem dos Médicos |
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Ordem dos Médicos |
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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 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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