PDF(Pubmed)
Abstract：
UNASSIGNED: Thirty-day hospital readmission measures quality of care, but there are limited data among people with HIV (PWH) and people without HIV (PWoH) in the era of universal recommendation for antiretroviral therapy. We descriptively compared 30-day all-cause, unplanned readmission risk between PWH and PWoH.
UNASSIGNED: A retrospective cohort study was conducted using the 2019 Nationwide Readmissions Database (2019/01/01-2019/12/31), an all-payer database that represents all US hospitalizations. Index (initial) admissions and readmissions were determined using US Centers for Medicare & Medicaid Services definitions. Crude and age-adjusted risk ratios (aRR) comparing the 30-day all-cause, unplanned readmission risk between PWH to PWoH were estimated using random effect logistic regressions and predicted marginal estimates. Survey weights were applied to all analyses.
UNASSIGNED: We included 24,338,782 index admissions from 18,240,176 individuals. The median age was 52(IQR = 40-60) years for PWH and 61(IQR = 38-74) years for PWoH. The readmission risk was 20.9% for PWH and 12.2% for PWoH (age-adjusted-RR:1.88 [95%CI = 1.84-1.92]). Stratified by age and sex, young female (age 18-29 and 30-39 years) PWH had a higher readmission risk than young female PWoH (aRR = 3.50 [95%CI = 3.11-3.88] and aRR = 4.00 [95%CI = 3.67-4.32], respectively). While the readmission risk increased with age among PWoH, the readmission risk was persistently high across all age groups among PWH. The readmission risk exceeded 30% for PWH admitted for hypertensive heart disease, heart failure, and chronic kidney disease.
UNASSIGNED: PWH have a disproportionately higher risk of readmission than PWoH, which is concerning given the aging profile of PWH. More efforts are needed to address readmissions among PWH.
UNASSIGNED: US National Institutes of Health.
UNASSIGNED: A retrospective cohort study was conducted using the 2019 Nationwide Readmissions Database (2019/01/01-2019/12/31), an all-payer database that represents all US hospitalizations. Index (initial) admissions and readmissions were determined using US Centers for Medicare & Medicaid Services definitions. Crude and age-adjusted risk ratios (aRR) comparing the 30-day all-cause, unplanned readmission risk between PWH to PWoH were estimated using random effect logistic regressions and predicted marginal estimates. Survey weights were applied to all analyses.
UNASSIGNED: We included 24,338,782 index admissions from 18,240,176 individuals. The median age was 52(IQR = 40-60) years for PWH and 61(IQR = 38-74) years for PWoH. The readmission risk was 20.9% for PWH and 12.2% for PWoH (age-adjusted-RR:1.88 [95%CI = 1.84-1.92]). Stratified by age and sex, young female (age 18-29 and 30-39 years) PWH had a higher readmission risk than young female PWoH (aRR = 3.50 [95%CI = 3.11-3.88] and aRR = 4.00 [95%CI = 3.67-4.32], respectively). While the readmission risk increased with age among PWoH, the readmission risk was persistently high across all age groups among PWH. The readmission risk exceeded 30% for PWH admitted for hypertensive heart disease, heart failure, and chronic kidney disease.
UNASSIGNED: PWH have a disproportionately higher risk of readmission than PWoH, which is concerning given the aging profile of PWH. More efforts are needed to address readmissions among PWH.
UNASSIGNED: US National Institutes of Health.
摘要：
■30天医院再入院测量护理质量，但在普遍推荐抗逆转录病毒治疗的时代,HIV感染者(PWH)和无HIV感染者(PWoH)的数据有限.我们描述性地比较了30天的全因，PWH和PWoH之间的计划外再入院风险。
■使用2019年全国再入院数据库（2019/01/01-2019/12/31）进行了一项回顾性队列研究，一个代表所有美国住院的所有付款人数据库.指数（初始）入院和再入院是使用美国医疗保险和医疗补助服务中心的定义确定的。比较30天全因的原油和年龄调整后的风险比(ARR)，使用随机效应逻辑回归和预测的边际估计值估计PWH至PWoH之间的非计划再入院风险。将调查权重应用于所有分析。
■我们包括了18,240,176个人的24,338,782名入学指标。PWH的中位年龄为52（IQR=40-60）岁，PWoH的中位年龄为61（IQR=38-74）岁。PWH的再入院风险为20.9%，PWoH的再入院风险为12.2%（年龄校正RR：1.88[95CI=1.84-1.92]）。按年龄和性别分层，年轻女性（年龄18-29岁和30-39岁）PWH的再入院风险高于年轻女性PWoH（aRR=3.50[95CI=3.11-3.88]和aRR=4.00[95CI=3.67-4.32]，分别)。虽然PWoH的再入院风险随着年龄的增加而增加，PWH各年龄组的再入院风险持续较高.因高血压心脏病入院的PWH再入院风险超过30%，心力衰竭,和慢性肾病。
■PWH比PWoH具有不成比例的更高的再入院风险，考虑到PWH的老化曲线。需要做出更多努力来解决PWH的再入院问题。
■美国国立卫生研究院。
■使用2019年全国再入院数据库（2019/01/01-2019/12/31）进行了一项回顾性队列研究，一个代表所有美国住院的所有付款人数据库.指数（初始）入院和再入院是使用美国医疗保险和医疗补助服务中心的定义确定的。比较30天全因的原油和年龄调整后的风险比(ARR)，使用随机效应逻辑回归和预测的边际估计值估计PWH至PWoH之间的非计划再入院风险。将调查权重应用于所有分析。
■我们包括了18,240,176个人的24,338,782名入学指标。PWH的中位年龄为52（IQR=40-60）岁，PWoH的中位年龄为61（IQR=38-74）岁。PWH的再入院风险为20.9%，PWoH的再入院风险为12.2%（年龄校正RR：1.88[95CI=1.84-1.92]）。按年龄和性别分层，年轻女性（年龄18-29岁和30-39岁）PWH的再入院风险高于年轻女性PWoH（aRR=3.50[95CI=3.11-3.88]和aRR=4.00[95CI=3.67-4.32]，分别)。虽然PWoH的再入院风险随着年龄的增加而增加，PWH各年龄组的再入院风险持续较高.因高血压心脏病入院的PWH再入院风险超过30%，心力衰竭,和慢性肾病。
■PWH比PWoH具有不成比例的更高的再入院风险，考虑到PWH的老化曲线。需要做出更多努力来解决PWH的再入院问题。
■美国国立卫生研究院。
