【摘 要】
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Objective We know little about hospital readmissions in China and the variation of readmissions rates after the initiation of Chinahealthcare system reform (HSR).We provided insights into the profile
【机 构】
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Department of Health Statistics, College of Public Health, Tianjin Medical University, No.22,Qixiang
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Objective We know little about hospital readmissions in China and the variation of readmissions rates after the initiation of Chinahealthcare system reform (HSR).We provided insights into the profile and variation of readmission after HSR in Tianjin,China.Methods We retrospectively used the Tianjin Medical Insurance Register System database to identify patients who were discharged alive from hospitals in Tianjin during years before and after the initiation of HSR (2008 and 2011).The 30, 60, 90 days raw and adjusted readmission rates were estimated for the top three most common diagnoses of admission.The Blinder-Oaxaca decomposition was used to explain the change in readmission.Results The top three common diagnoses for admission were Coronary Heart Disease (CHD), Cerebral Infarction (CI), and Diabetes Mellitus (DM).30-day readmission rates were higher than 60-day and 90-day readmission rates.Compared to 2008, 30-day adjusted-readmission rates for patients with CHD has increased in 2011 with a rate of 1.3%.For patients with CI, the 30-day readmission rate was 5.9% in 2008 and 8.2% in 2011, and were dramatically increased in tertiary (5.8% vs.9.2%, p<0.001) and teaching hospitals (5.6% vs.9.5%, p<0.001).A downward trend was found for DM patients between years (5.7% vs.4.4%, p<0.001).Owing to HSR and other unobservable influences, readmission rates were increased by 300.9%, 342.6%, and 311.2% for patients with CHD, CI and DM respectively.Conclusion The readmission was prevalence for patients discharged with CHD, CI and DM, and the readmission rates varied with different characteristics for different diseases.The HSR needs further strength, and it might drive the increase of readmission rates.The target interventions should be carried out to control its increase.
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