Schizophrenia and potentially preventable hospitalizations in the United States: a retrospective cross-sectional study
نویسندگان
چکیده
BACKGROUND Persons with schizophrenia may face barriers to high quality primary care due to communication difficulties, cognitive impairment, lack of social support, and fragmentation of healthcare delivery services. As a result, this group may be at high risk for ambulatory care sensitive (ACS) hospitalizations, defined as hospitalizations potentially preventable by timely primary care. The goal of this study was to determine if schizophrenia is associated with overall, acute, and chronic ACS hospitalizations in the United States (US). METHODS We conducted a retrospective cross-sectional study. Hospitalization data for the US were obtained from the Nationwide Inpatient Sample for years 2003-2008. We examined 15,275,337 medical and surgical discharges for adults aged 18-64, 182,423 of which had a secondary diagnosis of schizophrenia. ACS hospitalizations were measured using the Agency for Healthcare Research and Quality's Prevention Quality Indicators (PQIs). We developed logistic regression models to obtain nationally-weighted odds ratios (OR) for ACS hospitalizations, comparing those with and without a secondary diagnosis of schizophrenia after adjusting for patient, hospitalization, and hospital characteristics. RESULTS Schizophrenia was associated with increased odds of hospitalization for acute ACS conditions (OR = 1.34; 95% CI: 1.31, 1.38), as well as for chronic ACS conditions characterized by short-term exacerbations. Schizophrenia was associated with decreased odds of hospitalization for diabetes mellitus long-term complications and diabetes-related lower extremity amputation, conditions characterized by long-term deterioration. CONCLUSIONS Additional research is needed to determine which individual and health systems factors contribute to the increased odds of hospitalization for acute PQIs in schizophrenia.
منابع مشابه
Author's response to reviews Title: Schizophrenia and potentially preventable medical and surgical hospitalizations in the United States: a retrospective cross-sectional Study Authors:
متن کامل
Obsessive-Compulsive Disorder in Hospitalized Patients with Schizophrenia
Introduction: Comorbid obsessive-compulsive disorder (OCD) has been reported among patients with schizophrenia in other countries. But, the literature is not well-documented on this issue in Iran (Persia). The present study aimed to investigate the prevalence and severity of OCD and some of its related factors in a group of patients with schizophrenia in Iran. Methods: This is a cross-se...
متن کاملDuration of Hospital Stay in Alcohol/Substance Addictions and Psychiatric Disorders: A 12-Year Retrospective Analysis
Background: Mental disorders are generally a significant reason for increased morbidity. They constitute a serious disease burden. One of the main reasons for this disease burden is long hospitalization periods. Objective: The current study investigated the length of hospital stay and the variables affecting it in patients treated in the Gazi University H...
متن کاملContextualizing Obesity and Diabetes Policy: Exploring a Nested Statistical and Constructivist Approach at the Cross-National and Subnational Government Level in the United States and Brazil
Background This article conducts a comparative national and subnational government analysis of the political, economic, and ideational constructivist contextual factors facilitating the adoption of obesity and diabetes policy. Methods We adopt a nested analytical approach to policy analysis, which combines cross-national statistical analysis with subnational case study comparisons to examine...
متن کاملSurgical Procedures of the Elbow: A Nationwide Cross-Sectional Observational Study in the United States
Background: Elbow surgery is shared by several subspecialties. We were curious about the most common elbow surgeries and their corresponding diagnoses in the United States. Methods: We used the National Hospital Discharge Survey (NHDS) and the National Survey of Ambulatory Surgery (NSAS) data gathered in 2006-databases that together provide an estimate of all inpatient and ambulatory surgic...
متن کامل