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One-year rehospitalisations for congestive heart failure in Portuguese NHS hospitals

2019-09-01Artigo científico Acesso aberto
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dc.contributor.authorMoita, Bruno
dc.contributor.authorMarques, Ana Patricia
dc.contributor.authorCamacho, Ana Maria
dc.contributor.authorLeão Neves, Pedro
dc.contributor.authorSantana, Rui
dc.contributor.institutionCentro de Investigação em Saúde Pública (CISP/PHRC)
dc.contributor.institutionEscola Nacional de Saúde Pública (ENSP)
dc.contributor.pblBMJ Publishing Group
dc.date.accessioned2019-10-01T22:41:54Z
dc.date.available2019-10-01T22:41:54Z
dc.date.issued2019-09-01
dc.description.abstractObjectives Identification of rehospitalisations for heart failure and contributing factors flags health policy intervention opportunities designed to deliver care at a most effective and efficient level. Recognising that heart failure is a condition for which timely and appropriate outpatient care can potentially prevent the use of inpatient services, we aimed to determine to what extent comorbidities and material deprivation were predictive of 1 year heart failure specific rehospitalisation. Setting All Portuguese mainland National Health Service (NHS) hospitals. Participants A total of 68 565 hospitalisations for heart failure principal cause of admission, from 2011 to 2015, associated to 45 882 distinct patients aged 18 years old or over. Outcome measures We defined 1 year specific heart failure rehospitalisation and time to rehospitalisation as outcome measures. Results Heart failure principal diagnosis admissions accounted for 1.6% of total hospital NHS budget, and over 40% of this burden is associated to patients rehospitalised at least once in the 365-day follow-up period. 22.1% of the patients hospitalised for a principal diagnosis of heart failure were rehospitalised for the same cause at least once within 365 days after previous discharge. Nearly 55% of rehospitalised patients were readmitted within 3 months. Results suggest a mediation effect between material deprivation and the chance of 1 year rehospitalisation through the effect that material deprivation has on the prevalence of comorbidities. Heart failure combined with chronic kidney disease or chronic obstructive pulmonary disease increases by 2.8 and 2.2 times, respectively, the chance of the patient becoming a frequent user of inpatient services for heart failure principal cause of admission. Conclusions One-fifth of patients admitted for heart failure are rehospitalised due to heart failure exacerbation. While the role of material deprivation remained unclear, comorbidities considered increased the chance of 1 year heart failure specific rehospitalisation, in particular, chronic kidney disease and chronic obstructive pulmonary disease.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent255930
dc.identifier.doi10.1136/bmjopen-2019-031346
dc.identifier.issn2158-2440
dc.identifier.otherPURE: 14857926
dc.identifier.otherPURE UUID: 3e456fc0-b0b1-4e94-b911-6002d565aad5
dc.identifier.otherScopus: 85071748993
dc.identifier.otherPubMed: 31481570
dc.identifier.otherWOS: 000497787600362
dc.identifier.urihttp://www.scopus.com/inward/record.url?scp=85071748993&partnerID=8YFLogxK
dc.identifier.urlhttps://www.scopus.com/pages/publications/85071748993
dc.language.isoeng
dc.peerreviewedyes
dc.subjectambulatory care sensitive conditions
dc.subjectheart failure
dc.subjectmultilevel regression analysis
dc.subjectmultiple admissions
dc.subjectGeneral Medicine
dc.subjectSDG 3 - Good Health and Well-being
dc.titleOne-year rehospitalisations for congestive heart failure in Portuguese NHS hospitalsen
dc.title.subtitlea multilevel approach on patterns of use and contributing factorsen
dc.typejournal article
degois.publication.issue9
degois.publication.titleBMJ open
degois.publication.volume9
dspace.entity.typePublication
rcaap.rightsopenAccess

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