ArticleBMJ open2018
Determinants of patient choice for hospital readmission after township hospitalisation: a population-based retrospective study in China.
Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- An External Patient Healthcare Index (EPHI) for Simulating Spatial Tendencies in Healthcare Seeking Behavior.Frontiers in public health · 2022Article
- Performance and Sociodemographic Determinants of Excess Outpatient Demand of Rural Residents in China: A Cross-Sectional Study.International journal of environmental research and public health · 2020Article
- Is There a Difference in the Utilisation of Inpatient Services Between Two Typical Payment Methods of Health Insurance? Evidence from the New Rural Cooperative Medical Scheme in China.International journal of environmental research and public health · 2019Article
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3 authors.
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Abstract
objectiveThe lack of coordinated and appropriate healthcare across sectors has produced more patients for county hospitals in China. This study examined differences in patient choice between township and county hospitals for readmission after a first township hospitalisation, and the determinants that influenced this choice.
designA retrospective study of readmissions across hospitals after a first admission in township hospital. A township-township (TT) inpatient group and a township-county (TC) inpatient group were compared. A two-level logistic regression model was used to examine the determinants of choice for hospital readmission.
settingData were drawn from a population-based health utilisation database for Qianjiang District, China, from 1 January 2008 to 31 December 2013.
participantsThis study focused on readmitted patients whose first admission was in a township hospital. Readmission cases were identified as the same diagnosis (International Classification of Diseases, Tenth Revision) in a subsequent hospitalisation within 30 days. In total, 6764 readmissions had first admissions in township hospitals. PRIMARY OUTCOME MEASURES: Patient choice for hospital readmission after a first township hospitalisation.
resultsThe TT group accounted for 62.5% (4225) and the TC group for 37.5% (2539) of readmissions in 6 years, and the proportion of TC readmissions in total inpatients increased from 1.66% to 1.89%. Readmission rates varied among towns (p<0.001). Differences between the TC and TT groups included: length of stay (LOS) of first admission (6.96 days vs 9.23 days), average interval between admissions (6.03 days vs 14.95 days) and disease category. Admission year, age, travel time to county hospital, interval between admissions, first admission LOS and disease category were determinants of choice for hospital readmission.
conclusionsPatients whose first admission was in a township hospital were more likely to be readmitted to a county hospital. A combination of first LOS and interval between admissions may be an effective identification index for TC readmission. TRIAL REGISTRATION NUMBER: ChiCTR-OOR-14005563.
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