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논문 기본 정보

자료유형
학술저널
저자정보
Kim, Jae-Hyun (Department of Health Administration, Dankook University College of Health Science) Lee, Yunhwan (Department of Preventive Medicine and Public Health, Ajou University School of Medicine)
저널정보
한국보건행정학회 보건행정학회지 보건행정학회지 제29권 제2호
발행연도
2019.1
수록면
220 - 227 (8page)

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Background: Potentially avoidable hospitalizations (PAH) contribute to an increased post-discharge mortality. Methods: To investigate the between-hospital variation and the relationship between all predictors and mortality after discharge among older adults with PAH, we studied 15,186 older patients with PAH in 2,200 hospitals included in the National Health Insurance Service-Senior claims database from 2002 to 2013. Multivariable multilevel logistic regression analyses were performed to analyze the variance at between-hospital for mortality after accounting for differences in patient characteristics. Results: The between-hospital variation in mortality that could be attributed to hospital practice variations were 37.6% at 1-week to 13.9% at 12-month post-discharge, after adjustment for individual patient characteristics and hospital-level factors. Hospital-level factors significantly explained mortality at 3 weeks after discharge. Clinics, compared with general hospitals, demonstrated a 2.75 times higher likelihood of deaths at 3-week post-discharge (p<0.001). Compared with private hospitals, public hospitals exhibited 1.61 times higher odds of 3-week mortality (p=0.01). Conclusion: This study demonstrates considerable between-hospital variations in PAH-related mortality that could be attributed to hospital practices. Monitoring of hospitals to identify practice variations would be warranted to improve the survival of older patients with PAH.

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