Geographical variation analysis of all-cause hospital readmission cases in Winnipeg, Canada.

Yang Cui,Mahmoud Torabi,Xibiao Ye,Luis Oppenheimer,Colleen Metge,Michael Moffatt,Evelyn L Forget

doi:10.1186/s12913-015-0807-2

Abstract

BackgroundHospital readmission is costly and potentially avoidable. The concept of virtual wards as a new model of care is intended to reduce hospital readmissions by providing short-term transitional care to high-risk and complex patients in the community. In order to provide information regarding the development of virtual wards in the Winnipeg Health Region, Canada, this study used spatial statistics to identify geographic variations of hospital readmissions in 25 neighborhood clusters.MethodsThe data were obtained from the Population Health Research Data Repository housed at the Manitoba Centre for Health Policy. We used a Bayesian Disease Mapping approach which applied Markov chain Monte Carlo (MCMC) for cluster detection.ResultsBetween 2005/06 and 2008/09, 123,842 patients were hospitalized in all Winnipeg hospitals. Of these, 41,551 (33%) were readmitted to hospital in the year following discharge. Most of these readmitted patients (89.4%) had 1–2 readmissions, while 11.6% of readmitted patients had more than 2 readmissions after initial discharge. The smoothed age- and sex- adjusted relative risk rates of hospital readmission in 25 Winnipeg neighborhood clusters ranged between 0.73 and 1.27. We found that there were spatial cluster variations of hospital readmission across the Winnipeg Health Region. Seven neighborhood clusters are more likely to be significant potential clusters for hospital readmissions (p < .05), while six neighborhood clusters are less likely to be significant potential clusters.ConclusionsThis study provides the foundation and implementation guide for the Winnipeg Regional Health Authority virtual ward program. The findings will also help to improve long-term condition management in community settings and will help program planners to assure the efficient use of healthcare resources.

Highlights

Hospital readmission is costly and potentially avoidable
We found that there were spatial cluster variations of hospital readmission across the Winnipeg Health Region
From the Bayesian disease mapping (BYM) analysis, we found that seven neighborhood clusters {1, 7, 9, 10, Table 2 Relative risk rates of hospital readmissions in 25 Winnipeg neighborhood clusters

Summary

Introduction

Hospital readmission is costly and potentially avoidable. The concept of virtual wards as a new model of care is intended to reduce hospital readmissions by providing short-term transitional care to high-risk and complex patients in the community. Reducing avoidable hospital readmissions is key to. In order to reduce hospital readmission and costs, an intervention program known as “virtual wards” was initially introduced by Geraint Lewis in the United Kingdom (UK) [5]. The function of virtual wards is to reduce hospital readmissions by providing short-term transitional care from the hospital to the home to high-risk and complex patients in the community [6]. The goal of a virtual ward intervention is to improve the integration of health care for patients at high risk of future hospitalization. The use of the virtual ward is an appropriate form of home-based care for persons

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Discussion

Conclusion