Evidence map›Paper›PMID 29606125›Full record

ArticleBMC health services research2018

HIV and early hospital readmission: evaluation of a tertiary medical facility in Lilongwe, Malawi.

Kashmira Satish Chawla, Nora E Rosenberg, Christopher Stanley, Mitch Matoga, Alice Maluwa, Cecilia Kanyama, Jonathan Ngoma, Mina C Hosseinipour

Abstract read
In one paragraph

Article in BMC health services research, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Review
  5. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kashmira Satish ChawlaThe University of North Carolina Project-Malawi, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi.
Nora E RosenbergThe University of North Carolina Project-Malawi, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi.
Christopher StanleyThe University of North Carolina Project-Malawi, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi.
Mitch MatogaThe University of North Carolina Project-Malawi, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi.
Alice MaluwaThe University of North Carolina Project-Malawi, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi.
Cecilia KanyamaThe University of North Carolina Project-Malawi, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi. ckanyama@unclilongwe.org.
Jonathan NgomaThe Department of Medicine, Kamuzu Central Hospital, P.O. Box 149, 265, Lilongwe, Malawi.
Mina C HosseinipourThe University of North Carolina Project-Malawi, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi.

Funding

Virology, Immunology, and Microbiology CoreP30AI050410 · NIAID · UNIV OF NORTH CAROLINA CHAPEL HILL · PI DAVID M. MARGOLIS · 2001 to 2026
$76.9M
Fogarty Global Health Fellows Coordinating CenterR25TW009340 · FIC · UNIV OF NORTH CAROLINA CHAPEL HILL · PI CHI, BENJAMIN H. · 2012 to 2016
$6.9M
Malawi HIV Implementation Research Scientist Training Program (MHIRST)D43TW010060 · FIC · UNIV OF NORTH CAROLINA CHAPEL HILL · PI MINA CHRISTINE HOSSEINIPOUR, Victor Mwapasa · 2015 to 2026
$3.8M
Developing and Assessing a Male Engagement Intervention for Option B+ in MalawiK99MH104154 · NIMH · UNIV OF NORTH CAROLINA CHAPEL HILL · PI ROSENBERG, NORA · 2015 to 2016
$168k
FIC NIH HHS D43 TW010060FIC NIH HHS R25 TW009340Foundation for the National Institutes of Health K99 MH104154-01A1R25 TW009340, P30 AI50410NIAID NIH HHS P30 AI050410NIMH NIH HHS K99 MH104154
6 · The paper itself

Abstract

backgroundDelivery of quality healthcare in resource-limited settings is an important, understudied public health priority. Thirty-day (early) hospital readmission is often avoidable and an important indicator of healthcare quality.

methodsWe investigated the prevalence of all-cause early readmission and its associated factors using age and sex adjusted risk ratios (RR) and 95% confidence intervals (CI). A retrospective review of the medical ward database at Kamuzu Central Hospital in Lilongwe, Malawi was conducted between February and December 2013.

resultsThere were 3547 patients with an index admission of which 2776 (74.4%) survived and were eligible for readmission. Among these patients: 49.7% were male, mean age was 39.7 years, 36.1% were HIV-positive, 34.6% were HIV-negative, and 29.3% were HIV-unknown. The prevalence of early hospital readmission was 5.5%. Diagnoses associated with 30-day readmission were HIV-positive status (RR = 2.41; 95% CI: 1.64-3.53) and malaria (RR = 0.45; 95% CI: 0.22-0.91). Other factors associated with readmission were multiple diagnoses (excluding HIV) (RR = 1.52; 95% CI: 1.11-2.06), and prolonged length of stay (≥ 16 days) at the index hospitalization (RR = 3.63; 95% CI: 1.72-7.67).

conclusionTargeting HIV-infected inpatients with multiple diagnoses and longer index hospitalizations may prevent early readmission and improve quality of care.

Indexed as

AdolescentAdultAgedAge DistributionFemaleHIV InfectionsHospitalizationHospitalsHumansInpatientsMalawiMaleMiddle AgedPatient ReadmissionQuality of Health CareRetrospective StudiesHIVMalawiQualityReadmissionsSub-Saharan Africa

Identifiers

PMID29606125
PMCPMC5879607

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.