%0 Journal Article
%T Gender as risk factor for 30£¿days post-discharge hospital utilisation: a secondary data analysis
%A Brian Jack
%A Caroline Hesko
%A Jeffrey Greenwald
%A Julie O'Donnell
%A Michael Paasche-Orlow
%A Shaula Woz
%A Suzanne Mitchell
%A V K Chetty
%J -
%D 2012
%R 10.1136/bmjopen-2011-000428
%X 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][1]).

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¡ªbut not for women¡ªrisk 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.

 [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT00252057&atom=%2Fbmjopen%2F2%2F2%2Fe000428.ato
%U https://bmjopen.bmj.com/content/2/2/e000428