SMALL AREA VARIATIONS IN UNPLANNED REPEAT HOSPITALIZATION IN NOVA SCOTIA

Abstract

Objective: Unplanned readmission to hospital is widely used as an indicator of hospital performance. Community-based primary health care systems likely also play a role in unexpected returns to hospital. Our objective was to estimate the effect of community on the time to an unplanned, repeat hospitalization (URH) after an index discharge.

Approach: Using methods for small area rate estimation, we used an accelerated failure time model with a random effect for community to estimate the adjusted relative risk of experiencing an unplanned repeat hospitalization as a function of community of residence.

Results: Community of residence had a large and significant effect on the time to experiencing an URH. The risk of URH associated with living in particular communities can be larger than the adjusted risk of conditions like cardiovascular disease and diabetes.

Conclusion: Community of residence can play a substantial role in the time until someone returns to hospital unexpectedly.