schizophrenia and potentially preventable hospitalizations in the united states a retrospective cross-sectional study在美国精神分裂症和潜在可预防住院回顾横断面研究.pdfVIP

Cahoon et al. BMC Psychiatry 2013, 13:37 /1471-244X/13/37 RESEARCH ARTICLE Open Access Schizophrenia and potentially preventable hospitalizations in the United States: a retrospective cross-sectional study 1 2 3 3* Elizabeth Khaykin Cahoon , Emma E McGinty , Daniel E Ford and Gail L Daumit Abstract 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 s