Evidence map›Paper›PMID 30477505›Full record

ArticleBMC health services research2018

Unplanned readmission or death after discharge for Aboriginal and non-Aboriginal people with chronic disease in NSW Australia: a retrospective cohort study.

Amanda Jayakody, Christopher Oldmeadow, Mariko Carey, Jamie Bryant, Tiffany Evans, Stephen Ella, John Attia, Rob Sanson-Fisher

Open access · goldAbstract 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 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.0field-weighted citation impact, top 20% of its field
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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
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 at 2 institutions in 1 country.

Amanda JayakodyHealth Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia. amanda.jayakody@uon.edu.au.ORCID http://orcid.org/0000-0001-9123-1514
Christopher OldmeadowCREDITSS-Clinical Research Design, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, HMRI Building, New Lambton Heights, NSW, Australia.
Mariko CareyHealth Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia.
Jamie BryantHealth Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia.
Tiffany EvansCREDITSS-Clinical Research Design, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, HMRI Building, New Lambton Heights, NSW, Australia.
Stephen EllaNunyara Aboriginal Health Unit, Central Coast Local Health District, Ward Street, Gosford, NSW, Australia.
John AttiaCREDITSS-Clinical Research Design, Information Technology and Statistical Support Unit, Hunter Medical Research Institute, HMRI Building, New Lambton Heights, NSW, Australia.
Rob Sanson-FisherHealth Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Callaghan, NSW, 2308, Australia.
Hunter Medical Research Institute · AUCentral Coast Local Health District · AU

Funding

Priority Research Centre for Health Behaviour, University of Newcastle N/A
6 · The paper itself

Abstract

backgroundAdmitted patients with chronic disease are at high risk of an unplanned hospital readmission, however, little research has examined unplanned readmission among Aboriginal people in Australia. This study aimed to examine whether rates of unplanned 28 day hospital readmission, or death, significantly differ between Aboriginal and non-Aboriginal patients in New South Wales, Australia, over a nine-year period.

methodsA retrospective cohort analysis of a sample of de-identified linked hospital administrative data was conducted. Eligible patients were: 1) aged ≥18 years old, 2) admitted to an acute facility in a NSW public hospital between 30th June 2005 and 1st July 2014, and 3) admitted with either cardiovascular disease, chronic respiratory disease, diabetes or renal disease. The primary composite outcome was unplanned readmission or death within 28 days of discharge. Generalized linear models and a test for trend were used to assess rates of unplanned readmission or death over time in Aboriginal and non-Aboriginal patients with chronic disease, accounting for sociodemographic variables.

resultsThe final study cohort included 122,145 separations corresponding to 48,252 patients (Aboriginal = 57.2%, n = 27,601; non-Aboriginal = 42.8%, n = 20,651). 13.9% (n = 16,999) of all separations experienced an unplanned readmission or death within 28 days of discharge. Death within 28 days of discharge alone accounted for only a small number of separations (1.4%; n = 1767). Over the nine-year period, Aboriginal separations had a significantly higher relative risk of an unplanned readmission or death (Relative risk = 1.34 (1.29, 1.40); p-value < 0.0001) compared with non-Aboriginal separations once adjusted for sociodemographic, disease variables and restricted to < 75 years of age. A test for trend, including an interaction between year and Aboriginal status, showed there was no statistically significant change in proportions over the nine-year period for Aboriginal and non-Aboriginal separations (p-value for trend = 0.176).

conclusionAboriginal people with chronic disease had a significantly higher risk of unplanned readmission or death 28 days post discharge from hospital compared with non-Aboriginal people, and there has been no significant change over the nine year period. It is critical that effective interventions to reduce unplanned readmissions for Aboriginal people are identified.

Indexed as

AdolescentAdultAgedCohort StudiesFemaleHospitalizationHumansLogistic ModelsMaleMiddle AgedNew South WalesNoncommunicable DiseasesPatient ReadmissionPropensity ScoreRetrospective StudiesRiskAboriginal healthChronic diseaseData linkageHealth services researchUnplanned readmission

Identifiers

PMID30477505
PMCPMC6258493
OpenAlexW2903040965

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.