{"title":"Number of Readmissions and Its Determinants Among Patients With Heart Failure at Referral Hospitals in Amhara Region, Northwest Ethiopia: A Cross-Sectional Study Using Zero-Inflated Negative Binomial Model, 2023.","authors":"Mihretie Gedfew, Bekele Tesfaye, Haile Amha, Tirusew Wondie, Getnet Gedif, Wodajie Gietaneh, Tadesse Yirga Akalu, Lieltework Yismaw, Gedefaw Diress","doi":"10.1002/hsr2.70408","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Heart failure is a leading cause of hospital readmissions in the Amhara region, Northwest Ethiopia.</p><p><strong>Aim: </strong>This study aimed to determine the number of readmissions and identify the determinants among patients with heart failure at referral hospitals in the Amhara region, Northwest Ethiopia, in 2023.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 663 heart failure patients in Amhara region referral hospitals from September 2022 to February 2023. Simple random sampling was used for patient selection, and data were collected through chart reviews and interviewer-administered questionnaires. Zero-inflated negative binomial models were applied for data analysis. Data collection tools were pre-tested for reliability and validity.</p><p><strong>Results: </strong>Among 663 patients, 237 (35.7%) were readmitted at least once. An increased respiratory rate (IRR = 1.015; 95% CI: 1.0004, 1.031; <i>p</i> < 0.044) and longer medication duration (IRR = 1.011; 95% CI: 1.016, 1.051; <i>p</i> < 0.0001) were associated with more readmissions. Patients with poor social support had 59.4% fewer readmissions compared to those with good social support (IRR = -1.595; 95% CI: -0.02, -0.005; <i>p</i> < 0.041). A higher body mass index (IRR = 0.115; 95% CI: 0.035, 0.196; <i>p</i> < 0.004) was linked with a higher likelihood of remaining in the \"always-zero\" group, while an increased pulse rate reduced the odds (IRR = -0.013; 95% CI: -0.025, -0.008; <i>p</i> < 0.036). The mortality rate among readmitted patients was 11.39%.</p><p><strong>Conclusion: </strong>This study found significant readmission rates among HF patients. Factors such as respiratory rate and medication duration were linked to increased readmissions, while poor social support was associated with fewer readmissions, this likely reflects limited healthcare access in low- and middle-income countries among individuals with lower social support. The high mortality rate underscores the need for targeted interventions to improve patient outcomes.</p>","PeriodicalId":36518,"journal":{"name":"Health Science Reports","volume":"8 2","pages":"e70408"},"PeriodicalIF":2.1000,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783156/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Health Science Reports","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/hsr2.70408","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/2/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
摘要
背景：心力衰竭是埃塞俄比亚西北部阿姆哈拉地区再入院的主要原因：目的：本研究旨在确定2023年埃塞俄比亚西北部阿姆哈拉地区转诊医院心衰患者的再入院人数，并找出决定因素：从 2022 年 9 月到 2023 年 2 月，对阿姆哈拉地区转诊医院的 663 名心衰患者进行了横断面研究。研究采用简单随机抽样的方法选择患者，并通过病历审查和访谈者发放的问卷收集数据。数据分析采用零膨胀负二项模型。对数据收集工具的可靠性和有效性进行了预先测试：在 663 名患者中，237 人（35.7%）至少再次入院一次。呼吸道感染率增加（IRR = 1.015；95% CI：1.0004，1.031；p p p p p 结论：该研究发现了显著的再入院率：本研究发现，高血压患者的再入院率很高。呼吸频率和用药时间等因素与再入院率增加有关，而社会支持较差则与再入院率降低有关，这可能反映了在中低收入国家，社会支持较差的人获得医疗服务的机会有限。高死亡率凸显了采取针对性干预措施改善患者预后的必要性。
Number of Readmissions and Its Determinants Among Patients With Heart Failure at Referral Hospitals in Amhara Region, Northwest Ethiopia: A Cross-Sectional Study Using Zero-Inflated Negative Binomial Model, 2023.
Background: Heart failure is a leading cause of hospital readmissions in the Amhara region, Northwest Ethiopia.
Aim: This study aimed to determine the number of readmissions and identify the determinants among patients with heart failure at referral hospitals in the Amhara region, Northwest Ethiopia, in 2023.
Methods: A cross-sectional study was conducted with 663 heart failure patients in Amhara region referral hospitals from September 2022 to February 2023. Simple random sampling was used for patient selection, and data were collected through chart reviews and interviewer-administered questionnaires. Zero-inflated negative binomial models were applied for data analysis. Data collection tools were pre-tested for reliability and validity.
Results: Among 663 patients, 237 (35.7%) were readmitted at least once. An increased respiratory rate (IRR = 1.015; 95% CI: 1.0004, 1.031; p < 0.044) and longer medication duration (IRR = 1.011; 95% CI: 1.016, 1.051; p < 0.0001) were associated with more readmissions. Patients with poor social support had 59.4% fewer readmissions compared to those with good social support (IRR = -1.595; 95% CI: -0.02, -0.005; p < 0.041). A higher body mass index (IRR = 0.115; 95% CI: 0.035, 0.196; p < 0.004) was linked with a higher likelihood of remaining in the "always-zero" group, while an increased pulse rate reduced the odds (IRR = -0.013; 95% CI: -0.025, -0.008; p < 0.036). The mortality rate among readmitted patients was 11.39%.
Conclusion: This study found significant readmission rates among HF patients. Factors such as respiratory rate and medication duration were linked to increased readmissions, while poor social support was associated with fewer readmissions, this likely reflects limited healthcare access in low- and middle-income countries among individuals with lower social support. The high mortality rate underscores the need for targeted interventions to improve patient outcomes.
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