Multiple hospital admissions in a calendar year

Area of Science:

• Health Services Research
• Epidemiology
• Health Informatics

Background:

• Hospital workload is commonly quantified using episodes of care.
• Understanding the relationship between episodes of care and unique patients is crucial for accurate resource allocation and healthcare purchasing.
• Previous analyses have not fully explored variations in patient counts versus episode counts across different medical specialties and age demographics.

Purpose of the Study:

• To investigate the discrepancies between episode counts and patient counts within hospital care.
• To analyze how these discrepancies vary across different medical specialties and age groups.
• To provide data that can inform more accurate estimations of person-based admission rates from episode-based data.

Main Methods:

• Analysis of linked hospital care records for 1.9 million individuals over an 11-year period (1976-1986).
• Calculation of all-ages multiple admission ratios (admissions per 100 admitted patients) stratified by specialty and age.
• Examination of trends in multiple admission ratios over the study period.

Main Results:

• Multiple admission ratios varied significantly between specialties (102-171), with medical specialties generally showing higher ratios than surgical ones.
• The influence of age on multiple admission ratios differed by specialty, but ratios generally increased with age.
• While some minor increases in multiple admission ratios were observed over time, overall stability was more notable.

Conclusions:

• Episode counts can differ substantially from unique patient counts, necessitating careful consideration in healthcare management.
• Estimating person-based admission rates from episode data is feasible and valuable for managing hospital resources and purchasing care.
• Healthcare purchasers should be aware of both the number of episodes of care and the number of unique individuals treated.