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. 2017 Oct;96(42):e7953.
doi: 10.1097/MD.0000000000007953.

The prevalence and long-term variation of hospital readmission for patients with diabetes in Tianjin, China: A cross-sectional study

Xiaoqian Liu  1 , Yuting Guo, Dandan Li, Zhuang Cui, Yuanyuan Liu, Changping Li, Jun Ma
Affiliations

The prevalence and long-term variation of hospital readmission for patients with diabetes in Tianjin, China: A cross-sectional study

Xiaoqian Liu et al. Medicine (Baltimore). 2017 Oct.

Abstract

Little is known about hospital readmission for patients with diabetes in China. We aimed to assess the temporal pattern, risk factors, and variations of all-cause readmission among hospitalized patients with diabetes in Tianjin, China, from 2008 to 2013.The Tianjin Basic Medical Insurance Register System database was used to identify discharged patients with diabetes from 2008 to 2013. The influential factors and trends of rehospitalization were analyzed for 30-, 60- and 90-day predicted readmission rates. The Blinder-Oaxaca decomposition was used to explain the readmission variations between 2008 and 2013.The long stay-time at the index hospitalization is a shared risk factor for readmission at 30, 60, and 90 days each year. The 90-day predicted readmission rates were the highest for each year (all P < .001). The adjusted readmission rates generally decreased by year (all P < .001), except for at the 90-day interval, which decreased in 2010 and slightly increased in 2013 (from 7.47% in 2012 to 7.65% in 2013). If the patients had been readmitted to the hospital in 2013 and the only changes that had occurred since 2008 were observable characteristics, then the readmission rates would have decreased by 0.84%, 0.27%, and 0.18% at 30, 60, and 90 days, respectively. The potential policy changes decreased the readmission rates at 1.35%, 2.01%, and 1.04% for the 3 intervals, respectively.Identifying _targeted factors for the decrease in readmission rates may help to control readmission, particularly for long-interval patients.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1
Figure 1
The effect factors for 30-, 60-, and 90-day readmission rates in each year. (A) shows the effect factors for 30-day readmission rates from 2008 to 2013. (B) shows the effect factors for 60-day readmission rates for 2008 to 2013. (C) shows the effect factors for 90-day readmission rates from 2008 to 2013. The dark blue solid circles indicate the ORs that were significantly higher than 1 in each year (P < .05), the orange solid circles indicate the ORs that were significantly lower than 1 in each year (P < .05), and the gray solid circles indicate the ORs that were insignificant (P > .05). CHF = congestive heart failure, DCs = diabetes complications, FHD = family history of diabetes, HP = hypertension, LS = length of stay, PHD = previous diagnosed diabetes, RR = reimbursement ratio, SH = secondary hospitals, SN = screening history of diabetes, T2DM = type 2 diabetes, TH = tertiary hospitals.
Figure 2
Figure 2
The variation of readmission rates between 2008 and 2013. The solid dots indicate the predicted readmission rates and the bars indicate 95% confidence interval at 30, 60, and 90-day intervals in each year. CI = confidence interval.
See this image and copyright information in PMC

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