Active listing and more consultations in primary care are associated with shorter mean hospitalisation and interacting with psychiatric disorders when adjusting for multimorbidity, age and sex

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Ranstad, KarinLund University,Lunds universitet,Institutionen för kliniska vetenskaper, Malmö,Medicinska fakulteten,Department of Clinical Sciences, Malmö,Faculty of Medicine,Nättraby Primary Health Care Centre,Blekinge County Council (author)

Active listing and more consultations in primary care are associated with shorter mean hospitalisation and interacting with psychiatric disorders when adjusting for multimorbidity, age and sex

Article/chapterEnglish2018

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2018-09-21
Informa UK Limited,2018

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LIBRIS-ID:oai:lup.lub.lu.se:cf4dd8d0-daa8-42f5-a271-3ae0177d2e9a
https://lup.lub.lu.se/record/cf4dd8d0-daa8-42f5-a271-3ae0177d2e9aURI
https://doi.org/10.1080/02813432.2018.1499514DOI

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Language:English
Summary in:English

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Objective: Patient-provider relationships with primary care and need for hospitalisations are related within the complex networks comprising healthcare. Our objective was to analyse mean days hospitalised, using registration status (active or passive listing) with a provider and number of consultations as proxies of patient-provider relationships with primary care, adjusting for morbidity burden, age and sex while analysing the contribution of psychiatric disorders. The Johns Hopkins Adjusted Clinical Groups Case-Mix System was used to classify morbidity burden into Resource Utilization Band (RUB) 0-5. Design: Cross-sectional population study using zero-inflated negative binomial regression. Setting and subjects: All population in the Swedish County of Blekinge (N = 151 731) in 2007. Main outcome measure: Mean days hospitalised. Results: Actively listed were in mean hospitalised for 0.86 (95%CI 0.81–0.92) and passively listed for 1.23 (95%CI 1.09–1.37) days. For 0–1 consultation mean days hospitalised was 1.16 (95%CI 1.08–1.23) and for 4–5 consultations 0.68 (95%CI 0.62–0.75) days. At RUB3, actively listed were in mean hospitalised for 3.45 (95%CI 2.84–4.07) days if diagnosed with any psychiatric disorder and 1.64 (95%CI 1.50–1.77) days if not. Passively listed at RUB3 were in mean hospitalised for 5.17 (95%CI 4.36–5.98) days if diagnosed with any psychiatric disorder and 2.41 (95%CI 2.22–2.60) days if not. Conclusions: Active listing and more consultations were associated with a decrease in mean days hospitalised, especially for patients with psychiatric diagnoses. Implications: Promoting good relationships with primary care could be an opportunity to decrease mean days hospitalised, especially for patients with more complex diagnostic patterns.Key Points Primary care performance, patient-provider relationships and need for hospitalisation are related within the complex networks comprising healthcare systems. Good patient-provider relationships, i.e. more consultations and active listing, with primary care are associated with decreasing mean days hospitalised. The impact of patient-provider relationships in primary care on mean days hospitalised increased when psychiatric disorders added to patient complexity.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Allmänmedicin hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine General Practice hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Psykiatri hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Psychiatry hsv//eng
health services research
Hospitalization
mental disorders
multimorbidity
primary health care

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Midlöv, PatrikLund University,Lunds universitet,Institutionen för kliniska vetenskaper, Malmö,Medicinska fakulteten,Klinisk fysiologi och nuklearmedicin, Malmö,Forskargrupper vid Lunds universitet,Department of Clinical Sciences, Malmö,Faculty of Medicine,Clinical Physiology and Nuclear Medicine, Malmö,Lund University Research Groups(Swepub:lu)klin-pmi (author)
Halling, AndersLund University,Lunds universitet,Institutionen för kliniska vetenskaper, Malmö,Medicinska fakulteten,Department of Clinical Sciences, Malmö,Faculty of Medicine(Swepub:lu)med-ahn (author)
Institutionen för kliniska vetenskaper, MalmöMedicinska fakulteten (creator_code:org_t)

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In:Scandinavian Journal of Primary Health Care: Informa UK Limited36:3, s. 308-3160281-34321502-7724

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By the author/editor: Ranstad, Karin; Midlöv, Patrik; Halling, Anders

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