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. 2012 Apr 18;2(2):e000428.
doi: 10.1136/bmjopen-2011-000428. Print 2012.

Gender as risk factor for 30 days post-discharge hospital utilisation: a secondary data analysis

Shaula Woz  1 , Suzanne Mitchell, Caroline Hesko, Michael Paasche-Orlow, Jeffrey Greenwald, V K Chetty, Julie O'Donnell, Brian Jack
Affiliations

Gender as risk factor for 30 days post-discharge hospital utilisation: a secondary data analysis

Shaula Woz et al. BMJ Open. .

Abstract

Objective: In the 30 days after hospital discharge, hospital utilisation is common and costly. This study evaluated the association between gender and hospital utilisation within 30 days of discharge.

Design: Secondary data analysis using Poisson regression stratified by gender.

Participants: 737 English-speaking hospitalised adults from general medical service in urban, academic safety-net medical centre who participated in the Project Re-Engineered clinical trial (clinicaltrials.gov identifier: NCT00252057).

Main outcome measure: The primary end point was hospital utilisation, defined as total emergency department visits and hospital readmissions within 30 days after index discharge.

Results: Female subjects had a rate of 29 events for every 100 people and male subjects had a rate of 47 events for every 100 people (incident rate ratio (IRR) 1.62, 95% CI 1.28 to 2.06). Among men, risk factors included hospital utilisation in the 6 months prior to the index hospitalisation (IRR 3.55, 95% CI 2.38 to 5.29), being unmarried (IRR 1.72, 95% CI 1.12 to 2.64), having a positive depression screen (IRR 1.53, 95% CI 1.09 to 2.13) and no primary care physician (PCP) visit within 30 days (IRR 1.64, 95% CI 1.08 to 2.50). Among women, the only risk factor was hospital utilisation in the 6 months prior to the index hospitalisation (IRR 3.08, 95% CI 1.86 to 5.10).

Conclusions: In our data, male subjects had a higher rate of hospital utilisation within 30 days of discharge than female subjects. For men-but not for women-risk factors were being retired, unmarried, having depressive symptoms and having no PCP visit within 30 days. Interventions addressing these factors might lower hospital utilisation rates observed among men.

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Conflict of interest statement

Competing interests: None.

Figures

Figure 1
Figure 1
Kaplan–Meier curve: time to multiple hospitalisation events by gender.
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