Michael Gusmano1, Victor Rodwin2, Daniel Weisz3, Jonathan Cottenet4, Catherine Quantin5. 1. Research Scholar, Research department, The Hastings Center, New York, USA gusmanom@thehastingscenter.org. 2. Professor, The Robert F. Wagner School of Public Service, New York University, New York, USA. 3. Associate Research Scientist, The Robert N. Butler Columbia Center on Aging, Columbia University - International Longevity Center, New York, USA. 4. Statistician, Service de Biostatistique et d'Informatique Médicale (DIM), Centre Hospitalier Universitaire, France. 5. Researcher, Service de Biostatistique et d'Informatique Médicale (DIM), Centre Hospitalier Universitaire, Dijon, France Researcher, INSERM U866, Université de Bourgogne, France Researcher, INSERM, CIC1432, France.
Abstract
OBJECTIVE: To compare rates of 30-day all-cause rehospitalization in France and the US among patients aged 65 years and older and explain any difference between the countries. METHODS: To calculate rehospitalization rates in France, we use an individual identifying variable in the national hospital administrative dataset to track unique individuals aged 65 years or more hospitalized in France in 2010. To calculate the proportion of rehospitalized patients (65+) who received outpatient visits between the time of initial discharge and rehospitalization, we linked the hospital database with a database that includes all medical and surgical admissions. We used step by step regression models to predict rehospitalization. RESULTS: Rates of rehospitalization in France (14.7%) are lower than among Medicare beneficiaries in the US (20%). We find that age, sex, patient morbidity and the ownership status of the hospital are all correlated with rehospitalization in France. CONCLUSIONS: Lower rates of rehospitalization in France appear to be due to a combination of better access to primary care, better health among the older French population, longer lengths of stay in French hospitals and the fact that French nursing homes do not face the same financial incentive to rehospitalize residents.
OBJECTIVE: To compare rates of 30-day all-cause rehospitalization in France and the US among patients aged 65 years and older and explain any difference between the countries. METHODS: To calculate rehospitalization rates in France, we use an individual identifying variable in the national hospital administrative dataset to track unique individuals aged 65 years or more hospitalized in France in 2010. To calculate the proportion of rehospitalized patients (65+) who received outpatient visits between the time of initial discharge and rehospitalization, we linked the hospital database with a database that includes all medical and surgical admissions. We used step by step regression models to predict rehospitalization. RESULTS: Rates of rehospitalization in France (14.7%) are lower than among Medicare beneficiaries in the US (20%). We find that age, sex, patient morbidity and the ownership status of the hospital are all correlated with rehospitalization in France. CONCLUSIONS: Lower rates of rehospitalization in France appear to be due to a combination of better access to primary care, better health among the older French population, longer lengths of stay in French hospitals and the fact that French nursing homes do not face the same financial incentive to rehospitalize residents.
Authors: Jennifer Howlett; Eric Benzenine; Jonathan Cottenet; Pascal Foucher; Philippe Fagnoni; Catherine Quantin Journal: BMC Cancer Date: 2020-05-24 Impact factor: 4.430