Association of health confidence with hospital length of stay and readmission

IF 2.4 4区医学 Q1 MEDICINE, GENERAL & INTERNAL

Journal of hospital medicine Pub Date : 2024-05-16 DOI:10.1002/jhm.13405

Ashley E. Brown MD, MS, Valerie G. Press MD, MPH, David O. Meltzer MD, PhD

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引用次数: 0

Abstract

Background

Length of stay (LOS) is an important measure of hospital quality and may be impacted by patient participation. However, concepts of patient participation, like health confidence, have received little examination in hospitalized patients' LOS, especially in diverse populations.

Objective

To determine if the Health Confidence Score (HCS) is associated with hospital LOS and readmission in a socioeconomically diverse population.

Designs, Settings, and Participants

We conducted a prospective cohort study in 2022 of adult general medicine patients at an academic hospital in Chicago, Illinois.

Intervention

None.

Main Outcome and Measures

Patient-reported responses to the HCS (scored 0 [lowest health confidence] to ‒12 [highest health confidence]), as well as demographic, socioeconomic, and clinical questions, were collected. Primary outcome was LOS and secondary outcomes were 30- and 90-day readmission.

Results

Among 2797 socioeconomically diverse patients who completed the survey (response rate 28.5%), there was an average HCS of 9.19 (SD 2.68, range 0–12). Using linear regression, patients with high HCS (HCS ≥ 9) had a 1.53-day lower LOS (p < .01, 95% confidence interval [CI] [–2.11, –0.95]) than patients with a low HCS (HCS < 9). This association remained when examining individual HCS questions and controlling for covariates. In logistic regression, HCS was not significantly associated with readmission, but the question “I am involved in decisions about me” (adjusted model: odds ratio 0.83; 95% CI [0.71, 0.96]; p = .01) was associated with 90-day readmission.

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健康信心与住院时间和再入院率的关系。

背景：住院时间（LOS）是衡量医院质量的一个重要指标，可能会受到患者参与的影响。然而，病人参与的概念，如健康信心，在住院病人的 LOS 中很少得到研究，尤其是在不同的人群中：目的：确定健康信心分数（HCS）是否与社会经济多元化人群的住院时间和再入院率相关：我们于 2022 年在伊利诺伊州芝加哥市的一家学术医院对成人全科患者进行了一项前瞻性队列研究：主要结果和测量指标主要结果和测量方法：收集患者对 HCS（从 0 分[最低健康信心]到 -12 分[最高健康信心]）的反应，以及人口、社会经济和临床问题。主要结果为住院日，次要结果为 30 天和 90 天再入院：在完成调查的 2797 名社会经济背景各异的患者中（回复率为 28.5%），平均健康信心指数为 9.19（标准差为 2.68，范围为 0-12）。通过线性回归，高 HCS（HCS ≥ 9）患者的 LOS 比低 HCS（HCS < 9）患者低 1.53 天（p < .01，95% CI [-2.11, -0.95]）。当检查单个 HCS 问题并控制协变量时，这种关联仍然存在。在逻辑回归中，HCS 与再入院无显著相关性，但 "我参与了有关我的决策"（调整模型：OR 0.83；95% CI [0.71，0.96]；p = .01）与 90 天再入院相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of hospital medicine 医学-医学：内科

CiteScore

4.40

自引率

11.50%

发文量

233

审稿时长

4-8 weeks

期刊介绍： JHM is a peer-reviewed publication of the Society of Hospital Medicine and is published 12 times per year. JHM publishes manuscripts that address the care of hospitalized adults or children. Broad areas of interest include (1) Treatments for common inpatient conditions; (2) Approaches to improving perioperative care; (3) Improving care for hospitalized patients with geriatric or pediatric vulnerabilities (such as mobility problems, or those with complex longitudinal care); (4) Evaluation of innovative healthcare delivery or educational models; (5) Approaches to improving the quality, safety, and value of healthcare across the acute- and postacute-continuum of care; and (6) Evaluation of policy and payment changes that affect hospital and postacute care.