Journal of Shandong University (Health Sciences) ›› 2020, Vol. 58 ›› Issue (2): 90-95.doi: 10.6040/j.issn.1671-7554.0.2019.1457

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A study of unplanned readmission within 31 days during 2018 in a tertiary hospital in Jinan

ZHANG Yongyuan, WANG Qingliang, LI Xiangyi, LIU Yingjun, FEI Jianchun, YANG Jie   

  1. Medical Department, Qilu Hospital of Shandong University, Jinan 250012, Shandong, China
  • Online:2020-02-10 Published:2022-09-27

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Abstract: Objective To investigate the current status and influencing factors of unplanned readmission within 31 days after discharge in a tertiary hospital in Jinan. Methods A total of 2828 inpatients of unplanned readmission with 31 days during January 1st and December 31st, 2018 were enrolled. The descriptive analysis was employed, and Logistic regression was conducted to analyze the influencing factors. Results The unplanned readmission rate was 1.79%, and the mortality of unplanned readmission inpatients was 2.76%. The departments with high unplanned readmission rate focused on Department of Hepatology, Department of Rheumatology and Department of Geriatrics, and mainly due to chronic diseases and malignant tumors. The major influencing factors were inpatients age(OR=1.025,95%CI:1.023-1.028), previous length of stay in hospital(OR=1.021,95%CI:1.018-1.025), hospitalization times(OR=1.094,95%CI:1.087-1.101), district(OR=1.346, 95%CI: 1.244-1.455), marital status(unmarried: OR=3.280,95%CI:2.788-3.859; widowed: OR=1.954,95%CI:1.502-2.541), previous ways of discharge(discharge without doctors advice: OR=1.406,95%CI:1.173-1.685), previous operation(OR=0.628,95%CI:0.577-0.684)and medical insurance status(OR=0.594,95%CI:0.537-0.657). Conclusion The hospital should improve the supervision of unplanned readmission, standardize the diagnosis and treatment process, avoid decomposition of hospitalization, promote the hierarchical medical system, correctly guide the needs of patients, reduce the unplanned readmission rate and lighten the burden of patients.

Key words: Unplanned readmission, Medical quality, Hierarchical medical system, Chronic diseases, Influencing factor

CLC Number: 

  • R197.3
[1] Jencks SF, Williams MV, Coleman EA. Rehospitalizations among patients in the Medicare fee-for-service program[J]. N Engl J Med, 2009, 360(14): 1418-1428.
[2] 刘娟,杨栋,李系仁,等.某院31天内再入院现状与影响因素分析[J].中国卫生质量管理,2011,18(6):22-25. LIU Juan, YANG Dong, LI Xiren, et al. Status of readmission within 31 days and influencing factors analysis in one hospital[J]. Chinese Health Quality Management, 2011, 18(6): 22-25.
[3] 马谢民.国际医疗质量指标体系及其特点[J].中国医院管理,2007,27(11):22-24. MA Xiemin. The clinical indicator set for acute care hospitals and its major advantages[J]. Chinese Hospital Management, 2007, 27(11): 22-24.
[4] Thomas JW, Holloway JJ. Investigating early readmission as an indicator for quality of care studies[J]. Med Care, 1991, 29(4): 377-394.
[5] Milne R, Clarke A. Can readmission rates be used as an outcome indicator[J]. BMJ, 1990, 301(6761): 1139-1140.
[6] Chambers MA, Clarke A. Measuring readmission rates[J]. BMJ, 1990, 301(6761): 1134-1136.
[7] 陈丽.我国再入院率衡量住院医疗服务质量的适用性分析[J].中国医院管理,2016,36(1):48-50. CHEN Li. Applicability analysis of employ readmission rate to evaluate the quality of inpatient healthcare in China[J]. Chinese Hospital Management, 2016, 36(1): 48-50.
[8] Krumholz HM, Lin Z, Keenan PS, et al. Relationship between hospital readmission and mortality rates for patients hospitalized with acute myocardial infarction, heart failure, or pneumonia[J]. JAMA, 2013, 309(6): 587-593.
[9] McLean R, Mendis K, Canalize J. A ten-year retrospective study of unplanned hospital readmissions to a regional Australian hospital [J]. Aust Health Rev, 2008, 32(3): 537-547.
[10] 刘月辉,姚远.某三甲医院31天内非计划重返住院事件标准化信息监测与管理[J].中国卫生质量管理,2016,23(1):8-11. LIU Yuehui, YAO Yuan. Standardized information monitoring and management of unplanned readmission within 31 days after discharge in a third-level grade-A general hospital[J]. Chinese Health Quality Management, 2016, 23(1): 8-11.
[11] Benbassat J, Taragin M. Hospital readmissions as a measure of quality of health care: advantages and limitation[J]. Arch Intern Med, 2000, 160(8): 1074-1081.
[12] 国务院办公厅.关于推进分级诊疗制度建设的指导意见[S].国办发(2015)70号,2015.
[13] 李梅,贾爱芹,郭素雅.山西省三级甲等综合医院重点疾病重返情况分析[J].中国医院管理,2015,35(1):34-35. LI Mei, JIA Aiqin, GUO Suya. Analysis of key diseases re-entry status of class A tertiary general hospitals in Shanxi Province[J]. Chinese Hospital Management, 2015, 35(1): 34-35.
[14] 杨辉,Shane Thomas.再入院:概念、测量和政策意义[J].中国卫生质量管理, 2009,16(5):113-115. YANG Hui, SHANE Thomas. Readmission: concept, measurement and policy implications[J]. Chinese Health Quality Management, 2009, 16(5): 113-115.
[15] 吴文华,李丞,古瑞娟,等.基于logistic模型对某医院再住院病人影响因素分析[J].中国卫生统计,2013,12(1): 859-861.
[16] 周念松,张俊,马谢民,等.北京市某三甲医院31 天内非计划性再入院研究[J].中国医院管理,2010,30(4):18-20. ZHOU Niansong, ZHANG Jun, MA Xiemin, et al. The study of unplanned readmission within 31 days after being discharged in one general third-level grade A hospital in Beijing[J]. Chinese Hospital Management, 2010, 30(4): 18-20.
[17] 荣霞,邹郢,陈俐.住院患者2周内重复住院影响因素分析[J].中国病案,2015,16(1):60-62. RONG Xia, ZOU Ying, CHEN Li. Influencing factors analysis of the inpatients readmission within 2 weeks[J]. Chinese Medical Record, 2015, 16(1): 60-62.
[18] 陈琼,尹璇,张小悦,等. 31天内同类疾病非计划再住院病案首页填报的情况分析[J].中国病案,2018,19(4):10-12. CHEN Qiong, YIN Xuan, ZHANG Xiaoyue, et al. Analysis of non planned rehospitalization of similar diseases within 31 days[J]. Chinese Medical Record, 2018, 19(4): 10-12.
[19] 阮鹤瑞,刘晓明,金疆山,等.病案首页填写缺陷分析及对策建议[J].中国病案,2015,16(2):20-24. RUAN Herui, LIU Xiaoming, JIN Jiangshan, et al. Defect analysis and countermeasure suggestions of the front sheet of medical records[J]. Chinese Medical Record, 2015, 16(2): 20-24.
[20] 陈虎,焦雅辉,赵明钢,等.北京市五家大型综合医院“重返类”指标的比较分析[J].中国卫生质量管理,2010,17(1):4-7. CHEN Hu, JIAO Yahui, ZHAO Minggang, et al. A comparative analysis of "re-entry category" indicators in five major general hospitals in Beijing[J]. Chinese Health Quality Management, 2010, 17(1): 4-7.
[21] 黄锋,裴丽昆.平均住科日作为绩效指标的有效性研究[J].中国医院管理,2007,27(5):15-17. HUANG Feng, PEI Likun. A study about the validity of apply average length of stay in department as an indicator of performance[J]. Chinese Hospital Management, 2007, 27(5): 15-17.
[22] 申良荣,张鸿雁,孙忠民,等.出院患者非计划再入院影响因素分析[J].中国卫生质量管理,2018,25(5):35-38. SHEN Liangrong, ZHANG Hongyan, SUN Zhongmin, et al. Analysis of influencing factors of unplanned re-admission of discharged patients[J]. Chinese Health Quality Management, 2018, 25(5): 35-38.
[23] 刘君,刘霞,何梦乔.缩短平均住院日对策[J].解放军医院管理杂志,2010,17(1):59-60. LIU Jun, LIU Xia, HE Mengqiao. Measures of shorten ALOS[J]. Hospital Administration Journal of Chinese Peoples Liberation Army, 2010, 17(1): 59-60.
[24] 田伟,初爱娟,尹桂华,等. 31天内重复住院病例分析[J].中国病案,2017,18(1):74-77. TIAN Wei, CHU Aijuan, YIN Guihua, et al. Case analysis on the inpatients readmission within 31 days[J]. Chinese Medical Record, 2017, 18(1): 74-77.
[25] 周少玲,吕鹏,王淑艳.出院31天内非计划再入院的管理实践[J].中国医疗管理科学,2015,5(5):24-26. ZHOU Shaoling, LV Peng, WANG Shuyan, et al. Discussion on the management over unplanned readmission within 31 days after discharge[J]. Chinese Journal of Medical Management Sciences, 2015, 5(5): 24-26.
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