ArticlePloS one2022
Social inequalities, length of hospital stay for chronic conditions and the mediating role of comorbidity and discharge destination: A multilevel analysis of hospital administrative data linked to the population census in Switzerland.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed.
- Characterization of orthogeriatric care models and association with mortality and health-economic outcomes in patients with hip fractures: a retrospective cohort study from Germany.BMC geriatrics · 2026Article
- Mediating effects between social capital and health care utilization in Italy-a structural equation model analysis.Population health metrics · 2025Article
- The Impact of Public Health Interventions on the Frequency and Duration of Hospitalisations Among Seniors in Poland-An Analysis Covering the Years 2017-2018.Journal of clinical medicine · 2025Article
- Machine learning-based predictions of healthcare contacts following emergency hospitalisation using electronic health records.NPJ digital medicine · 2025Article
- Compounding risks of chronic health conditions and substance use disorder on healthcare burden in the USA: Analysis of NSDUH data (2021-2023).Addictive behaviors reports · 2025Article
- Impact of social determinants of health on sepsis outcomes: a retrospective study of a single centre in the USA.BMJ open · 2025Article
- Living alone and provider behaviour in public and private hospitals.Journal of health economics · 2025Article
- Frailty and hospital outcomes among patients with neurological disorders.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Article
- A Quality Improvement Project to Reduce Rapid Response System Inequities for Patients with Limited English Proficiency at a Quaternary Academic Medical Center.Journal of general internal medicine · 2024Article
- Total Abdominal Colectomy Versus Diverting Loop Ileostomy and Antegrade Colonic Lavage for Fulminant Clostridioides Colitis: Analysis of the National Inpatient Sample 2016-2019.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Hospital length of stay and 30-day readmissions in older people: their association in a 20-year cohort study in Italy.BMC geriatrics · 2023Article
- Article
- Social and Regional Factors Predict the Likelihood of Admission to a Nursing Home After Acute Hospital Stay in Older People With Chronic Health Conditions: A Multilevel Analysis Using Routinely Collected Hospital and Census Data in Switzerland.Frontiers in public health · 2022Article
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4 authors.
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Abstract
Social factors are recognized determinants of morbidity and mortality and also have an impact on use of medical services. The objective of this study was to assess the associations of educational attainment, social and financial resources, and migration factors with length of hospital stays for chronic conditions. In addition, the study investigated the role of comorbidity and discharge destination in mediating these associations. The study made use of nationwide inpatient data that was linked with Swiss census data. The study sample included n = 141,307 records of n = 92,623 inpatients aged 25 to 84 years, hospitalized between 2010 and 2016 for a chronic condition. Cross-classified multilevel models and mediation analysis were performed. Patients with upper secondary and compulsory education stayed longer in hospital compared to those with tertiary education (β 0.24 days, 95% CI 0.14-0.33; β 0.37, 95% CI 0.27-0.47, respectively) when taking into account demographic factors, main diagnosis and clustering on patient and hospital level. However, these effects were almost fully mediated by burden of comorbidity. The effect of living alone on length of stay (β 0.60 days, 95% CI 0.50-0.70) was partially mediated by both burden of comorbidities (33%) and discharge destination (30.4%). (Semi-) private insurance was associated with prolonged stays, but an inverse effect was observed for colon and breast cancer. Allophone patients had also prolonged hospital stays (β 0.34, 95% CI 0.13-0.55). Hospital stays could be a window of opportunity to discern patients who need additional time and support to better cope with everyday life after discharge, reducing the risks of future hospital stays. However, inpatient care in Switzerland seems to take into account rather obvious individual needs due to lack of immediate support at home, but not necessarily more hidden needs of patients with low health literacy and less resources to assert their interests within the health system.
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