In a spatial analysis of 123,842 hospitalized patients in Winnipeg, 33% were readmitted within one year, with significant geographic variation showing adjusted relative risks ranging from 0.73 to 1.27 across neighborhood clusters.
Observational (n=123,842)
Significant spatial variation exists in all-cause hospital readmissions across Winnipeg neighborhoods, which can inform the targeted deployment of community-based transitional care programs.
Effect estimate: RR 0.73 to 1.27
p-value: p=<0.05
BACKGROUND: 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. 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. METHODS: The 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. RESULTS: Between 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. CONCLUSIONS: This 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.
Cui et al. (Wed,) conducted a observational in All-cause hospital readmission (n=123,842). Geographic location (neighborhood cluster) vs. Overall regional average was evaluated on Hospital readmission within one year of discharge (RR 0.73 to 1.27, p=<0.05). In a spatial analysis of 123,842 hospitalized patients in Winnipeg, 33% were readmitted within one year, with significant geographic variation showing adjusted relative risks ranging from 0.73 to 1.27 across neighborhood clusters.