中国全科医学2025，Vol.28Issue(19)：2370-2375,6.DOI:10.12114/j.issn.1007-9572.2024.0252
老年高血压患者可避免住院的影响因素研究
Analysis of Factors Influencing Avoidable Hospitalization for Elderly Hypertensive Patients
摘要
Abstract
Background While many studies have focused on the hospitalization costs of hypertensive patients,few have examined avoidable hospitalization in hypertensive patients using big data.Objective This study aims to assess the prevalence of avoidable hospitalization among elderly hypertensive patients in Guangdong Province,providing insights for the integration and optimization of healthcare resources in the province's medical communities.Methods Health data for elderly individuals in Guangdong and hospitalization records from 2022 were integrated using the Guangdong Province Primary Healthcare Information Management System,the Guangdong Province Universal Health Information Platform,and inpatient case data.Influencing factors such as the number of general practitioners(GPs)per 10 000 population and the number of visits to primary healthcare institutions were obtained from the 2022 Guangdong Provincial Health Statistics Yearbook.A Logistic regression model was used to analyze the factors contributing to avoidable hospitalization.Results The rate of avoidable hospitalization among elderly hypertensive patients in Guangdong Province was 8.76%.The likelihood of avoidable hospitalization was significantly higher in females[OR(95%CI)=1.231(1.217-1.246)]compared to males.Using 90 years and older as a reference,hypertensive patients aged 65-69,70-74,75-79,and 80-84 years were 2.044[OR(95%CI)=2.044(1.981-2.109)],and 1.640 times more likely to avoid the occurrence of hospitalization than older hypertensive patients aged 90 years and older,respectively[OR(95%CI)=1.640(1.590-1.693)],1.288 times[OR(95%CI)=1.288(1.248-1.329)],and 1.110 times[OR(95%CI)=1.110(1.073-1.147)].Using a GDP per capita of less than 100 000 yuan as a reference,hypertensive patients with a GDP per capita of 100 000 yuan and above were 1.314 times more likely to have an avoidable incidence of hospitalization than those with a GDP per capita of less than 100 000 yuan[OR(95%CI)=1.314(1.278-1.350)].When the number of GPs was≥4 per 10 000 population,hypertensive patients were 1.039 times more likely to have avoidable hospitalization compared to those in areas with fewer than 4 GPs per 10 000 population[OR(95%CI)=1.039(1.105-1.063)].The probability of avoidable hospitalization decreased by 40.60%when the number of secondary and tertiary hospitals per 10 000 population was less than 0.20[OR(95%CI)=0.594(0.570-0.619)].Finally,compared to areas with fewer than 3 visits per capita to secondary and tertiary hospitals or grassroots institutions,those with≥3 visits per capita had a 1.047 times higher probability of avoidable hospitalization in secondary and tertiary hospitals[OR(95%CI)=1.047(1.021-1.074)],and a 1.229 times higher probability in grassroots institutions[OR(95%CI)=1.229(1.191-1.268)].Conclusion Gender and age are significant factors influencing avoidable hospitalization in elderly hypertensive patients.Higher GDP per capita,greater visit frequency,and more GPs were associated with increased likelihood of avoidable hospitalization,while the number of secondary and tertiary hospitals did not contribute to this risk.关键词
高血压/老年人/可避免住院/影响因素分析/广东省Key words
Hypertension/Aged/Avoidable hospitalization/Root cause analysis/Guangdong province分类
临床医学引用本文复制引用
郝爱华,聂辉,杨颖,曾子莹,金爱琼,唐玲玲,郑梓悫,马景泰,赵建国,曾韦霖,肖建鹏..老年高血压患者可避免住院的影响因素研究[J].中国全科医学,2025,28(19):2370-2375,6.基金项目
广东省医学科研基金指令性课题项目(C2023007) （C2023007）
