Understanding the large heterogeneity in hospital readmissions and mortality for acute myocardial infarction

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Lobo, MF (Author) FMUP; Azzone, V (Author) Other; Lopes, F (Author) Other; Freitas A (Author) FMUP; Costa-Pereira A (Author) FMUP; Normand, SL (Author) Other; Teixeira Pinto, A (Author) Other

Journal

Title: Health Policy

Vol. 124

Pages: 684-694

ISSN: 0168-8510

Publisher: Elsevier

Indexing

ISI Web of Knowledge - 1 Citation

Scopus - 1 Citation

Other information

Authenticus ID: P-00S-8W1

DOI: 10.1016/j.healthpol.2020.04.004

Abstract (EN): This study aims to investigate the variation in two acute myocardial infarction (AMI) outcomes across public hospitals in Portugal. In-hospital mortality and 30-day unplanned readmissions were studied using two distinct AMI cohorts of adults discharged from all acute care public hospital centers in Portugal from 2012-2015. Hierarchical generalized linear models were used to assess the association between patient and hospital characteristics and hospital variability in the two outcomes. Our findings indicate that hospitals are not performing homogeneously-the risk of adverse events tends to be consistently larger in some hospitals and consistently lower in other hospitals. While patient characteristics accounted for a larger share of the explained between-hospital variance, hospital characteristics explain an additional 8% and 10% of hospital heterogeneity in the mortality and the readmission cohorts respectively. Admissions to hospitals with low AMI caseloads or located in Alentejo/Algarve and Lisbon had a higher risk of mortality. Discharges from larger-sized hospitals were associated with increased risk of readmissions. Future health policies should incorporate these findings in order to incentivize more consistent health care outcomes across hospitals. Further investigation addressing geographical disparities, hospital caseload and practices is needed to direct actions of improvement to specific hospitals. (C) 2020 Published by Elsevier B.V.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 11