[Hospital LOS, medical complexity and deprivation indicators]. / Lien précarité - durée et complexité des séjours hospitaliers en secteur de court séjour.
Rev Epidemiol Sante Publique
; 57(3): 205-11, 2009 Jun.
Article
em Fr
| MEDLINE
| ID: mdl-19442465
ABSTRACT
BACKGROUND:
Several studies have shown that socioeconomic deprivation is associated with increased hospitalization lengths of stay (LOS) and costs. Yet, the French DRG-based information system (PMSI) does not take deprived situations into account. Hence, we aimed at extracting routinely available variables measuring deprivation from the Hospital Information System and at assessing their association with severity of illness and hospital LOS.METHODS:
We performed record linkage between the PMSI database concerning stays of patients aged more than 16years in the short-stay sector of Assistance publique-Hôpitaux de Paris in 2007 and an administrative database which provided the following deprivationmeasures:
recipients of Couverture Médicale Universelle (basic or complementary health insurances adapted for underprivileged French citizens) or Aide Médicale d'Etat (health and medical emergency insurances adapted for underprivileged non French citizens living in France) and homeless patients. We compared length of stays showing a deprivation measure to others after adjustment on morbidity, age and sex.RESULTS:
Among 352,721 stays, the prevalence of the deprivation measures ranged from 0.71% for "homelessness" to 6.24% for complementary Couverture Médicale Universelle. Stays showing a deprivation measure had specific illnesses and had more frequently associated comorbidities or complications than others. After adjustment, deprivation measures were associated with significantly increased LOS (by 5% for Couverture Médicale Universelle to 48% for emergency Aide Médicale d'Etat.CONCLUSION:
Routine extraction of deprivation measures from Hospital Information Systems is feasible. Age, sex and illness being equal, these deprivation measures were associated with more complicated cases and increased LOS. We recommend that case mix-based hospital prospective payment systems take socioeconomic deprivation into account.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pobreza
/
Grupos Diagnósticos Relacionados
/
Populações Vulneráveis
/
Tempo de Internação
Tipo de estudo:
Clinical_trials
/
Etiology_studies
/
Prevalence_studies
/
Risk_factors_studies
Limite:
Adolescent
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Adult
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Aged
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Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
Fr
Revista:
Rev Epidemiol Sante Publique
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
França