Multimorbidity and healthcare resource utilization in Switzerland: a multicentre cohort study.

Détails

Ressource 1Télécharger: 31623664_BIB_8A4026AAAD77.pdf (503.01 [Ko])
Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_8A4026AAAD77
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Multimorbidity and healthcare resource utilization in Switzerland: a multicentre cohort study.
Périodique
BMC health services research
Auteur(s)
Aubert C.E., Fankhauser N., Marques-Vidal P., Stirnemann J., Aujesky D., Limacher A., Donzé J.
ISSN
1472-6963 (Electronic)
ISSN-L
1472-6963
Statut éditorial
Publié
Date de publication
17/10/2019
Peer-reviewed
Oui
Volume
19
Numéro
1
Pages
708
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: epublish
Résumé
Multimorbidity is associated with higher healthcare resource utilization, but we lack data on the association of specific combinations of comorbidities with healthcare resource utilization. We aimed to identify the combinations of comorbidities associated with high healthcare resource utilization among multimorbid medical inpatients.
We performed a multicentre retrospective cohort study including 33,871 multimorbid (≥2 chronic diseases) medical inpatients discharged from three Swiss hospitals in 2010-2011. Healthcare resource utilization was measured as 30-day potentially avoidable readmission (PAR), prolonged length of stay (LOS) and difference in median LOS. We identified the combinations of chronic comorbidities associated with the highest healthcare resource utilization and quantified this association using regression techniques.
Three-fourths of the combinations with the strongest association with PAR included chronic kidney disease. Acute and unspecified renal failure combined with solid malignancy was most strongly associated with PAR (OR 2.64, 95%CI 1.79;3.90). Miscellaneous mental health disorders combined with mood disorders was the most strongly associated with LOS (difference in median LOS: 17 days) and prolonged LOS (OR 10.77, 95%CI 8.38;13.84). The number of chronic diseases was strongly associated with prolonged LOS (OR 9.07, 95%CI 8.04;10.24 for ≥10 chronic diseases), and to a lesser extent with PAR (OR 2.16, 95%CI 1.75;2.65 for ≥10 chronic diseases).
Multimorbidity appears to have a higher impact on LOS than on PAR. Combinations of comorbidities most strongly associated with healthcare utilization included kidney disorders for PAR, and mental health disorders for LOS.
Mots-clé
Aged, Chronic Disease/epidemiology, Chronic Disease/therapy, Female, Humans, Male, Middle Aged, Multimorbidity, Patient Acceptance of Health Care/statistics & numerical data, Retrospective Studies, Switzerland/epidemiology, Chronic diseases, Combinations, Comorbidity, Healthcare utilization, Length of stay, Potentially avoidable readmission, Readmission
Pubmed
Web of science
Open Access
Oui
Création de la notice
21/10/2019 15:00
Dernière modification de la notice
15/01/2021 7:10
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