Variation in management of community-acquired pneumonia requiring admission to Alberta, Canada hospitals Export

@article{Jin2003, abstract = {Previous studies have shown small area variation in the rate of admission to hospital for patients with community-acquired pneumonia. We determined the rates of admission and length of stay for patients with community-acquired pneumonia in Alberta and the factors influencing admission rates and length of stay. Using hospital abstracts, hospital admissions for community-acquired pneumonia from 1 April 1994 to 31 March 1999 were compared. We classified Alberta hospitals according to geographical regions, by the number of beds, and by number of community-acquired pneumonia cases. There were 12,000 annual hospital discharges for community-acquired pneumonia costing over \$40 million per year. The overall in-hospital mortality rate was 12\% and the 1 year mortality rate was 26\%. Compared with rural hospitals, regional and metropolitan hospitals admitted patients with greater severity of illness as demonstrated by greater in-hospital mortality, cost per case and comorbidity. Age-sex adjusted hospital discharge rates were significantly below the provincial average in both urban regions. Hospital discharge rates for residents in all rural regions and 4 of 5 regions with a regional hospital were significantly higher than the provincial average. After adjusting for comorbidity, the relative risk for a longer length of stay was 22\% greater in regional hospitals and about 30\% greater in urban hospitals compared to rural hospitals. Seasonal variation in the admission rate was evident, with higher rates in the winter of each year. We conclude that rural hospitals would be likely to benefit from a protocol to help with the admission decision and urban hospitals from a programme to reduce length of stay.}, author = {Jin, Y. and Marrie, T. J. and Carriere, K. C. and Predy, G. and Houston, C. and Ness, K. and Johnson, D. H.}, citeulike-article-id = {1130049}, journal = {Epidemiol Infect}, keywords = {80, admission, adolescent, adult, aged, albertaepidemiology, analysis, and, atlas, classificationutilization, community-acquired, control, costs, data, dischargestatistics, economics, epidemiologymortalitypathologyprevention, female, govt, hospital, hospitals, humans, illness, index, infections, length, linear, male, middle, models, mortality, non-us, numerical, of, over, patient, pneumonia, research, review, ruraleconomicsutilization, seasons, severity, small-area, statistics, stay, support, urbaneconomicsutilization, utilization}, month = {Feb}, number = {1}, pages = {41--51}, posted-at = {2007-02-28 15:56:00}, priority = {2}, title = {Variation in management of community-acquired pneumonia requiring admission to Alberta, Canada hospitals}, volume = {130}, year = {2003} }

TY - JOUR ID - Jin2003 L3 - citeulike-article-id:1130049 N2 - Previous studies have shown small area variation in the rate of admission to hospital for patients with community-acquired pneumonia. We determined the rates of admission and length of stay for patients with community-acquired pneumonia in Alberta and the factors influencing admission rates and length of stay. Using hospital abstracts, hospital admissions for community-acquired pneumonia from 1 April 1994 to 31 March 1999 were compared. We classified Alberta hospitals according to geographical regions, by the number of beds, and by number of community-acquired pneumonia cases. There were 12,000 annual hospital discharges for community-acquired pneumonia costing over $40 million per year. The overall in-hospital mortality rate was 12% and the 1 year mortality rate was 26%. Compared with rural hospitals, regional and metropolitan hospitals admitted patients with greater severity of illness as demonstrated by greater in-hospital mortality, cost per case and comorbidity. Age-sex adjusted hospital discharge rates were significantly below the provincial average in both urban regions. Hospital discharge rates for residents in all rural regions and 4 of 5 regions with a regional hospital were significantly higher than the provincial average. After adjusting for comorbidity, the relative risk for a longer length of stay was 22% greater in regional hospitals and about 30% greater in urban hospitals compared to rural hospitals. Seasonal variation in the admission rate was evident, with higher rates in the winter of each year. We conclude that rural hospitals would be likely to benefit from a protocol to help with the admission decision and urban hospitals from a programme to reduce length of stay. IS - 1 JF - Epidemiol Infect EP - 51 TI - Variation in management of community-acquired pneumonia requiring admission to Alberta, Canada hospitals VL - 130 SP - 41 KW - 80 KW - admission KW - adolescent KW - adult KW - aged KW - albertaepidemiology KW - analysis KW - and KW - atlas KW - classificationutilization KW - community-acquired KW - control KW - costs KW - data KW - dischargestatistics KW - economics KW - epidemiologymortalitypathologyprevention KW - female KW - govt KW - hospital KW - hospitals KW - humans KW - illness KW - index KW - infections KW - length KW - linear KW - male KW - middle KW - models KW - mortality KW - non-us KW - numerical KW - of KW - over KW - patient KW - pneumonia KW - research KW - review KW - ruraleconomicsutilization KW - seasons KW - severity KW - small-area KW - statistics KW - stay KW - support KW - urbaneconomicsutilization KW - utilization AU - Jin, Y AU - Marrie, TJ AU - Carriere, KC AU - Predy, G AU - Houston, C AU - Ness, K AU - Johnson, DH PY - 2003/Feb// ER -