Chronic illness and hospital readmission rate by adult age groups

Jayasree Basu
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Abstract

Objective: The study provides a comprehensive assessment of readmission risks of patients by nonelderly adult and elderly age groups admitted with different chronic condition types and multiple chronic condition (MCC) burdens.Methods: The study examines the all-cause readmission risks of hospitalized adult patients in 18-64 and 65 and above age groups admitted for any cause having three mutually exclusive chronic condition types: Ambulatory Care Sensitive Condition (ACSC); non-ACSC, and non-chronic. Using 2009 hospital discharge data from HCUP-SID of AHRQ, linked to the contextual and provider data from HRSA, a multilevel logistic regression model is applied on data pooled over 5 states adjusting for patient, hospital, and community characteristics.Results: The hospitalized elderly with chronic ACSC has higher risks of readmissions than those without, or relative to the nonelderly with chronic ACSC. However, nonelderly adults faced steeper increases in risks of readmissions than the elderly in response to increased MCC burden, irrespective of types of chronic conditions.Conclusions: A lower number of ACSCs is associated with higher reduction in the risks of readmission in the elderly than in the nonelderly adults. Management of chronic conditions in general is associated with reduced readmission risks across all age groups, more so for nonelderly adults.
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按成人年龄组划分的慢性病和再入院率
目的:对不同慢性疾病类型和多重慢性疾病(MCC)负担的非老年成人和老年人群再入院风险进行综合评估。方法:研究18-64岁和65岁及以上年龄组因任何原因入院的三种相互排斥的慢性疾病类型的成年住院患者的全因再入院风险:门诊敏感疾病(ACSC);非acsc,非慢性。利用来自AHRQ的hcups - sid的2009年医院出院数据,与来自HRSA的上下文和提供者数据相关联,对超过5个州的数据池应用了多级逻辑回归模型,对患者、医院和社区特征进行了调整。结果:住院的老年慢性ACSC患者再入院的风险高于无慢性ACSC患者,或相对于非老年慢性ACSC患者。然而,无论慢性疾病类型如何,非老年人在MCC负担增加的情况下,再入院风险比老年人增加得更快。结论:与非老年人相比,较低数量的ACSCs与老年人再入院风险的降低相关。一般来说,慢性病的管理与所有年龄组再入院风险的降低有关,对非老年人来说更是如此。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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