HIV and early hospital readmission: evaluation of a tertiary medical facility in Lilongwe, Malawi Public Deposited

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Creator
  • Maluwa, Alice
    • Other Affiliation: The University of North Carolina Project-Malawi, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi
  • Chawla, Kashmira S
    • Other Affiliation: The University of North Carolina Project-Malawi, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi
  • Ngoma, Jonathan
    • Other Affiliation: The Department of Medicine, Kamuzu Central Hospital, P.O. Box 149, 265 Lilongwe, Malawi
  • Hosseinipour, Mina
    • Affiliation: School of Medicine, Division of Infectious Diseases, Department of Medicine
    • Other Affiliation: The University of North Carolina Project-Malawi, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi
  • Stanley, Christopher
    • Other Affiliation: The University of North Carolina Project-Malawi, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi
  • Matoga, Mitch
    • Other Affiliation: The University of North Carolina Project-Malawi, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi
  • Kanyama, Cecilia
    • Other Affiliation: The University of North Carolina Project-Malawi, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi; The Department of Medicine, Kamuzu Central Hospital, P.O. Box 149, 265 Lilongwe, Malawi
  • Rosenberg, Nora E
    • Affiliation: School of Medicine, Division of Infectious Diseases, Department of Medicine
    • Other Affiliation: The University of North Carolina Project-Malawi, Tidziwe Centre, Private Bag A-104, Lilongwe, Malawi
Abstract
  • Abstract Background Delivery of quality healthcare in resource-limited settings is an important, understudied public health priority. Thirty-day (early) hospital readmission is often avoidable and an important indicator of healthcare quality. Methods We investigated the prevalence of all-cause early readmission and its associated factors using age and sex adjusted risk ratios (RR) and 95% confidence intervals (CI). A retrospective review of the medical ward database at Kamuzu Central Hospital in Lilongwe, Malawi was conducted between February and December 2013. Results There were 3547 patients with an index admission of which 2776 (74.4%) survived and were eligible for readmission. Among these patients: 49.7% were male, mean age was 39.7 years, 36.1% were HIV-positive, 34.6% were HIV-negative, and 29.3% were HIV-unknown. The prevalence of early hospital readmission was 5.5%. Diagnoses associated with 30-day readmission were HIV-positive status (RR = 2.41; 95% CI: 1.64–3.53) and malaria (RR = 0.45; 95% CI: 0.22–0.91). Other factors associated with readmission were multiple diagnoses (excluding HIV) (RR = 1.52; 95% CI: 1.11–2.06), and prolonged length of stay (≥ 16 days) at the index hospitalization (RR = 3.63; 95% CI: 1.72–7.67). Conclusion Targeting HIV-infected inpatients with multiple diagnoses and longer index hospitalizations may prevent early readmission and improve quality of care.
Date of publication
Identifier
  • doi:10.1186/s12913-018-3050-9
Resource type
  • Article
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  • In Copyright
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  • The Author(s).
Language
  • English
Bibliographic citation
  • BMC Health Services Research. 2018 Apr 02;18(1):225
Publisher
  • BioMed Central
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