The relationship between hospital admission rates and rehospitalizations.
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2011 Dec 15;365(24):2287-95. doi: 10.1056/NEJMsa1101942.The relationship between hospital admission rates and rehospitalizations.1, , .1Department of Health Policy and Management, Harvard School of Public Health, 677 Huntington Ave., Boston, MA 02115, USA. aepstein@hsph.harvard.eduAbstractBACKGROUND: Efforts to reduce hospital readmissions have focused primarily on improving transitional care. Yet variation in readmission rates may more closely reflect variation in the underlying hospitalization rates than differences in the quality of care during and after discharge.METHODS: We used national Medicare data to calculate, for each local hospital referral region (HRR), the 30-day, 60-day, and 90-day readmission rates among patients discharged with congestive heart failure or pneumonia. We also calculated population-based all-cause admission rates among Medicare enrollees in each HRR. We examined the variation in HRR readmission rates that was explained by overall hospitalization rates versus differences in patients' coexisting conditions, quality of discharge planning, physician supply, and bed supply.RESULTS: HRR readmission rates ranged from 11 to 32% for congestive heart failure and from 8 to 27% for pneumonia. In univariate analyses, all-cause admission rates accounted for the highest proportion of regional variation in readmission rates for congestive heart failure (28%, 34%, and 37% at 30, 60, and 90 days, respectively); the next highest proportions were explained by case mix (11%, 15%, and 18%) and the number of cardiologists per capita (12%, 14%, and 15%). Results for pneumonia were similar, except that the number of pulmonologists per capita accounted for a lower proportion of the variation (6%, 8%, and 7%, respectively). In multivariate analyses, admission rates accounted for 16 to 24% of the variation for congestive heart failure and 11 to 20% no other factor accounted for more than 6%.CONCLUSIONS: We found a substantial association between regional rates of rehospitalization and overall admission rates. Programs directed at shared savings from lower utilization of hospital services might be more successful in reducing readmissions than programs initiated to date. (Funded by the Commonwealth Fund.).PMID:
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medical evacuation[英][ˈmedikəl ɪˌvækju:ˈeɪʃən][美][ˈmɛdɪkəl ɪˌvækjuˈeʃən][医]医疗后送; 以上结果来自金山词霸例句:双语英语1.Today, babur is a taliban medical evacuation destination. 今天,巴布尔是塔利班医疗后送目的地.2.Emergency medical assistance, medical evacuation& repatriation ( or overseas funeral expenses) 紧急医疗救助、医疗转运和送返（或国外丧葬费）3.In addition, the u. s. military medical evacuation and intelligence capabilities unique to the beginning of the withdrawal will not be affected. 除此之外,医疗疏散和情报等美军独有的能力在撤军一开始不会受到影响.4.International medical assistance including arrangement of hospital admission, payment guarantee and emergency medical evacuation and repatriation. 国际医疗救援,包括安排入院许可,费用垫付和紧急医疗运送.5.Emergency medical assistance, medical evacuation and repatriation ( or overseas funeral expenses) 紧急医疗救助、医疗转运和送返、遗体送返（或国外丧葬费）如果您有什么疑问和不解之处,欢迎追问我!如果您认可我的答案,请采纳.您的采纳,是我答题的动力,O(∩_∩)O谢谢}