TIMELY MUNICIPALITY REHABILITATION AFTER HOSPITALISATION REDUCES READMISSION AND EARLY MORTALITY.

Søren Bie Bogh, Sören Möller, Mette Birk-Olsen, Lars Morsø
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Abstract

Objective: Firstly, the study explores the association between timely initiation of rehabilitation and 90-day and 365-day all-cause acute readmission and secondly, 90-day and 365-day all-cause mortality in a cohort of Odense Municipality residents.

Methods: The registry-based observational cohort study investigates acute contacts at Odense University Hospital from 2015 to 2020. Descriptive statistics, Cox regression and cumulative incidence rates were used for analysis.

Subjects: The study utilizes initiated rehabilitation referrals within 60 days from Odense Municipality residents.

Results: In total, 7,377 rehabilitation plans were initiated, including 5051 (68.5%) within the legal timeframe. Overall, timely initiation of rehabilitation within the legal timeframe was associated with a significantly reduced risk of 90-day all-cause acute readmission (Adjusted HR 0.82, 95% CI 0.74-0.90).In the adjusted analysis, timely initiation was also significantly associated with reduced risk in 365-day all-cause acute readmission (HR 0.90, 95% CI 0.83-0.97). Each week of delay in initiation of rehabilitation was associated with an increased risk of readmission (HR 1.05, 95% CI 1.02-1.07). Further, timely initiation of rehabilitation was associated with a significant reduction in the risk of 365-day all-cause mortality (HR 0.74, 95% CI 0.61-0.89).

Conclusion: Timely initiation of rehabilitation within the legal timeframe of 7 or 14 days was associated with significantly reduced risk of 90-day and 365-day all-cause acute readmission. Timely initiation of rehabilitation was also associated with significant reduction in the risk of 365-day all-cause mortality.

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住院后及时进行市政康复可减少再次入院和早期死亡率。
研究目的:首先,该研究探讨了及时开始康复治疗与欧登塞市居民队列中 90 天和 365 天全因急性再入院之间的关系;其次,探讨了 90 天和 365 天全因死亡率之间的关系:这项以登记为基础的观察性队列研究调查了 2015 年至 2020 年期间欧登塞大学医院的急性联系人。研究采用描述性统计、Cox 回归和累积发病率进行分析:研究对象为欧登塞市居民在60天内的康复转诊:总共启动了 7377 项康复计划,其中 5051 项(68.5%)在法定时限内启动。总体而言,在法定时限内及时启动康复计划与90天全因急性再入院风险的显著降低有关(调整后HR为0.82,95% CI为0.74-0.90)。在调整后的分析中,及时启动康复计划与365天全因急性再入院风险的降低也有显著关系(HR为0.90,95% CI为0.83-0.97)。每延迟一周开始康复治疗,再入院风险就会增加(HR 1.05,95% CI 1.02-1.07)。此外,及时开始康复治疗与365天全因死亡风险的显著降低有关(HR 0.74,95% CI 0.61-0.89):结论:在 7 天或 14 天的法定期限内及时开始康复治疗与 90 天和 365 天全因急性再入院风险的显著降低有关。及时开始康复治疗还能显著降低 365 天全因死亡的风险。
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