Thirty‐Day Readmission and Cost Analysis in Patients With Cirrhosis: A Nationwide Population‐Based Data
Accurate population‐based data are needed on the rate, economic impact, and the long‐term outcomes of readmission among patients with cirrhosis. To examine the rates, costs, and 1‐year outcomes of patients readmitted within 30 days following their index hospitalization for complications of cirrhosis...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Health/LWW
2020-03-01
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| Series: | Hepatology Communications |
| Online Access: | https://doi.org/10.1002/hep4.1472 |
| _version_ | 1797934655064768512 |
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| author | Sakkarin Chirapongsathorn Kittiyod Poovorawan Ngamphol Soonthornworasiri Wirichada Pan‐ngum Kamthorn Phaosawasdi Sombat Treeprasertsuk |
| author_facet | Sakkarin Chirapongsathorn Kittiyod Poovorawan Ngamphol Soonthornworasiri Wirichada Pan‐ngum Kamthorn Phaosawasdi Sombat Treeprasertsuk |
| author_sort | Sakkarin Chirapongsathorn |
| collection | DOAJ |
| description | Accurate population‐based data are needed on the rate, economic impact, and the long‐term outcomes of readmission among patients with cirrhosis. To examine the rates, costs, and 1‐year outcomes of patients readmitted within 30 days following their index hospitalization for complications of cirrhosis, we conducted a nationwide, population‐based cohort study involving all patients with cirrhosis in Thailand from 2009 through 2013, using data from the National Health Security Office databases, which included those from nationwide hospitalizations. Readmission was captured from hospitals at all health care levels across the country within the Universal Coverage Scheme. For the 134,038 patients hospitalized with cirrhosis, the overall 30‐day readmission rate was 17%. Common causes of readmission consisted of complications of portal hypertension (47%) and infections (17%). After adjusting for multiple covariates, predictors of 30‐day readmission included hepatocellular carcinoma (odds ratio [OR] 1.95, 95% confidence interval [CI] 1.84‐2.06), human immunodeficiency virus–related admission (OR 1.81, 95% CI 1.51‐2.17) and cholangiocarcinoma (OR 1.64, 95% CI 1.3‐2.05). In all, 2,936 deaths (13%) occurred during readmission, and an additional 14,425 deaths up to 1 year (63.5% total mortality among readmitted patients). Causes of death were mostly from liver‐related mortality. Average cost at index admission for those with a 30‐day readmission were significantly higher than those readmitted beyond 30 days or not readmitted. Conclusions: Patients hospitalized with cirrhosis complications had high rates of unscheduled 30‐day readmission. Average hospitalization costs were high, and only 36.5% of patients readmitted within 30 days survived at 1 year. |
| first_indexed | 2024-04-10T18:02:19Z |
| format | Article |
| id | doaj.art-0f42aff93d224879bfe74b4dcf311a90 |
| institution | Directory Open Access Journal |
| issn | 2471-254X |
| language | English |
| last_indexed | 2024-04-10T18:02:19Z |
| publishDate | 2020-03-01 |
| publisher | Wolters Kluwer Health/LWW |
| record_format | Article |
| series | Hepatology Communications |
| spelling | doaj.art-0f42aff93d224879bfe74b4dcf311a902023-02-02T14:27:57ZengWolters Kluwer Health/LWWHepatology Communications2471-254X2020-03-014345346010.1002/hep4.1472Thirty‐Day Readmission and Cost Analysis in Patients With Cirrhosis: A Nationwide Population‐Based DataSakkarin Chirapongsathorn0Kittiyod Poovorawan1Ngamphol Soonthornworasiri2Wirichada Pan‐ngum3Kamthorn Phaosawasdi4Sombat Treeprasertsuk5Division of Gastroenterology and Hepatology Department of Medicine Phramongkutklao Hospital College of Medicine, Royal Thai Army Bangkok ThailandDepartment of Clinical Tropical Medicine Faculty of Tropical Medicine Mahidol University Bangkok ThailandDepartment of Tropical Hygiene Faculty of Tropical Medicine Mahidol University Bangkok ThailandDepartment of Tropical Hygiene Faculty of Tropical Medicine Mahidol University Bangkok ThailandDivision of Gastroenterology Vichaiyut Hospital Bangkok ThailandDivision of Gastroenterology Department of Medicine Chulalongkorn University Bangkok ThailandAccurate population‐based data are needed on the rate, economic impact, and the long‐term outcomes of readmission among patients with cirrhosis. To examine the rates, costs, and 1‐year outcomes of patients readmitted within 30 days following their index hospitalization for complications of cirrhosis, we conducted a nationwide, population‐based cohort study involving all patients with cirrhosis in Thailand from 2009 through 2013, using data from the National Health Security Office databases, which included those from nationwide hospitalizations. Readmission was captured from hospitals at all health care levels across the country within the Universal Coverage Scheme. For the 134,038 patients hospitalized with cirrhosis, the overall 30‐day readmission rate was 17%. Common causes of readmission consisted of complications of portal hypertension (47%) and infections (17%). After adjusting for multiple covariates, predictors of 30‐day readmission included hepatocellular carcinoma (odds ratio [OR] 1.95, 95% confidence interval [CI] 1.84‐2.06), human immunodeficiency virus–related admission (OR 1.81, 95% CI 1.51‐2.17) and cholangiocarcinoma (OR 1.64, 95% CI 1.3‐2.05). In all, 2,936 deaths (13%) occurred during readmission, and an additional 14,425 deaths up to 1 year (63.5% total mortality among readmitted patients). Causes of death were mostly from liver‐related mortality. Average cost at index admission for those with a 30‐day readmission were significantly higher than those readmitted beyond 30 days or not readmitted. Conclusions: Patients hospitalized with cirrhosis complications had high rates of unscheduled 30‐day readmission. Average hospitalization costs were high, and only 36.5% of patients readmitted within 30 days survived at 1 year.https://doi.org/10.1002/hep4.1472 |
| spellingShingle | Sakkarin Chirapongsathorn Kittiyod Poovorawan Ngamphol Soonthornworasiri Wirichada Pan‐ngum Kamthorn Phaosawasdi Sombat Treeprasertsuk Thirty‐Day Readmission and Cost Analysis in Patients With Cirrhosis: A Nationwide Population‐Based Data Hepatology Communications |
| title | Thirty‐Day Readmission and Cost Analysis in Patients With Cirrhosis: A Nationwide Population‐Based Data |
| title_full | Thirty‐Day Readmission and Cost Analysis in Patients With Cirrhosis: A Nationwide Population‐Based Data |
| title_fullStr | Thirty‐Day Readmission and Cost Analysis in Patients With Cirrhosis: A Nationwide Population‐Based Data |
| title_full_unstemmed | Thirty‐Day Readmission and Cost Analysis in Patients With Cirrhosis: A Nationwide Population‐Based Data |
| title_short | Thirty‐Day Readmission and Cost Analysis in Patients With Cirrhosis: A Nationwide Population‐Based Data |
| title_sort | thirty day readmission and cost analysis in patients with cirrhosis a nationwide population based data |
| url | https://doi.org/10.1002/hep4.1472 |
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