About: Emergency department visits and hospital readmissions in an Argentine health system

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An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Emergency department visits and hospital readmissions in an Argentine health system
Creator	Ación, Laura Boietti, Bruno Bonella, Maria Giunta, Diego Luna, Daniel Marquez Fosser, Santiago Martínez, Bernardo Pollan, Javier Florencia, María Fosser, Santiago Martínez D E, Bernardo Ratti, Grande
Source	Elsevier; Medline; PMC
abstract	BACKGROUND AND GOAL OF STUDY: The scope of health in the Sustainable Development Goals is much broader than the Millennium Development Goals, spanning functions such as health-system access and quality of care. Hospital readmission rate and ED-visits within 30 days from discharge are considered low-cost quality indicators. This work assesses an indicator of quality of care in a tertiary referral hospital in Argentina, using data available from clinical records. PURPOSE: To estimate the rate of ED-visits and the hospital readmission rate (HRR) after a first hospitalization (First-H), and to identify associated factors. METHODS: This retrospective cohort included patients who had a First-H in Hospital Italiano de Buenos Aires between 2014-2015. Follow-up occurred from discharge until ED-visit, readmission, death, disaffiliation from health insurance, or 13 months. We present HRR at 30 days and ED-visits rate at 72 hours, using the Cox proportional-hazards regression model to explore associated factors, and reporting adjusted hazard ratios (HR) with their respective 95%CI. RESULTS: The study comprised 10,598 hospitalizations (median age was 68 years). Of these, 5,966 had at least one consultation to the ED during follow up, resulting in a 24 hour rate of consultations to ED of 1.51% (95%CI 1.29-1.72); at 48 hours 3.18% (95%CI 2.86-3.54); at 72 hours 4.71% (95%CI 4.32-5.13). In multivariable models, factors associated for 72 hours ED-visits were: age (aHR 1.06), male (aHR 1.14), Charlson Comorbidity Index (aHR 1.16), unscheduled hospitalization (aHR 1.39), prior consultation with the ED (aHR 1.08) and long hospital stay (aHR 1.39). Meanwhile, 2,345 patients had at least one hospital readmission (98% unscheduled), resulting a 24 hour rate of 0.5% (95%CI 0.42-0.71), at 48 hours 0.98% (95%CI 0.80-1.18), at 72 hours 1.4% (95%CI 1.2-1.6); at 30 days 7.7% (95%CI 7.2-8.2); at 90 days 13% (95%CI 12.4-13.8); and one-year 22.5% (95%CI 21.7-23.4). Associated factors for HRR at 30 days were: age (HR 1.16), male (HR 1.09), Charlson comorbidities score (HR 1.27), social service requirement during First-H (HR 1.37), unscheduled First-H (HR 1.16), previous ED-visits (HR 1.03) and length of stay (HR 1.08). CONCLUSION: Priorities efforts to improve must include greater attention to patients' readiness prior discharge, to explore causes of preventable readmissions, and better support for patient self-management.
has issue date	2020-07-22(xsd:dateTime)
bibo:doi	10.1016/j.ijmedinf.2020.104236
bibo:pmid	32721852
has license	no-cc
sha1sum (hex)	16d0173d9c8489f87b75b203799b9929a2903547
schema:url	https://doi.org/10.1016/j.ijmedinf.2020.104236
resource representing a document's title	Emergency department visits and hospital readmissions in an Argentine health system
has PubMed Central identifier	PMC7373686
has PubMed identifier	32721852
schema:publication	Int J Med Inform
resource representing a document's body	covid:16d0173d9c8489f87b75b203799b9929a2903547#body_text
is schema:about of	named entity 'hospital readmissions' named entity 'ACCESS' named entity 'STRATEGIES' named entity 'INITIATIVE' named entity 'IMPROVEMENT' named entity 'THESE' named entity 'COST' named entity 'SCOPE' named entity 'TO REDUCE' named entity 'INDICATORS' named entity 'PREVENTABLE' named entity 'QUALITY CARE' named entity 'hospital readmission' named entity 'reduce' named entity 'affiliations' named entity 'Emergency department' named entity 'Emergency department' named entity 'argentine' named entity 'risk factors' named entity 'hospital readmission' named entity 'social support' named entity 'private insurance' named entity 'electronic medical record' named entity 'long time' named entity 'COVID-19' named entity 'health services' named entity 'comorbidities' named entity 'Health systems' named entity 'follow-up' named entity 'metadata' named entity 'Taiwan' named entity 'critical care' named entity 'Clinical Data' named entity 'EHR' named entity 'SDG' named entity 'CCI' named entity 'electronic health records' named entity 'statistical analyses' named entity 'global goals' named entity 'medical supply' named entity 'well-being' named entity 'EDs' named entity 'continuum of care' named entity 'risk factors' named entity 'medical care' named entity 'follow-up' named entity 'health insurance' named entity 'hospital discharge' named entity 'Emergency Department' named entity 'tertiary hospital' named entity 'hospital stays' named entity 'hospital discharge' named entity 'pediatric patients' named entity 'regression model' named entity 'survival data' named entity 'health care' named entity 'COPD' named entity 'sample size' named entity 'informed decision' named entity 'hospital discharge' named entity 'CCI' named entity 'Risk factors' named entity 'hospital discharge' named entity '2030 Agenda for Sustainable Development' named entity 'risk factors' named entity 'Code of Ethics' named entity 'Ethics' named entity 'hospital readmission' named entity 'cohort study' named entity 'selection bias'

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