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14 years of follow-up from the Edinburgh randomised trial of breast-cancer screening.

https://arctichealth.org/en/permalink/ahliterature20979
Source
Lancet. 1999 Jun 5;353(9168):1903-8
Publication Type
Article
Date
Jun-5-1999
Author
F E Alexander
T J Anderson
H K Brown
A P Forrest
W. Hepburn
A E Kirkpatrick
B B Muir
R J Prescott
A. Smith
Author Affiliation
Department of Community Health Sciences, University of Edinburgh, UK. freda.alexander@ed.ac.uk
Source
Lancet. 1999 Jun 5;353(9168):1903-8
Date
Jun-5-1999
Language
English
Publication Type
Article
Keywords
Age Factors
Breast Neoplasms - mortality - prevention & control - radiography
Cohort Studies
Female
Follow-Up Studies
Health Services Research
Humans
Logistic Models
Mammography - utilization
Mass Screening - utilization
Middle Aged
Research Support, Non-U.S. Gov't
Scotland - epidemiology
Survival Rate
Time Factors
Abstract
BACKGROUND: The Edinburgh randomised trial of breast-cancer screening recruited women aged 45-64 years from 1978 to 1981 (cohort 1), and those aged 45-49 years during 1982-85 (cohorts 2 and 3). Results based on 14 years of follow-up and 270,000 woman-years of observation are reported. METHODS: Breast-cancer mortality rates in the intervention group (28,628 women offered screening) were compared with those in the control group (26,026) with adjustment for socioeconomic status (SES) of general medical practices. Rate ratios were derived by means of logistic regression for the total trial population and for women first offered screening while younger than 50 years. Analyses were by intention to treat. FINDINGS: Initial unadjusted results showed a difference of just 13% in breast-cancer mortality rates between the intervention and control groups (156 deaths [5.18 per 10,000] vs 167 [6.04 per 10,000]; rate ratio 0.87 [95% CI 0.70-1.06]), but the results were influenced by differences in SES by trial group. After adjustment for SES, the rate ratio was 0.79 (95% CI 0.60-1.02). When deaths after diagnosis more than 3 years after the end of the study were censored the rate ratio became 0.71 (0.53-0.95). There was no evidence of heterogeneity by age at entry and no evidence that younger entrants had smaller or delayed benefit (rate ratio 0.70 [0.41-1.20]). No breast-cancer mortality benefit was observed for women whose breast cancers were diagnosed when they were younger than 50 years. Other-cause mortality rates did not differ by trial group when adjusted for SES. INTERPRETATION: Our findings confirm results from randomised trials in Sweden and the USA that screening for breast cancer lowers breast-cancer mortality. Similar results are reported by the UK geographical comparison, UK Trial of Early Detection of Breast Cancer. The results for younger women suggest benefit from introduction of screening before 50 years of age.
Notes
Comment In: Lancet. 1999 Jun 5;353(9168):1896-710371561
Comment In: Lancet. 1999 Sep 11;354(9182):946-710489974
Comment In: Lancet. 1999 Sep 11;354(9182):946; author reply 94710489973
Comment In: Lancet. 1999 Sep 11;354(9182):947-810489975
Comment In: Lancet. 2001 Dec 22-29;358(9299):2165; author reply 2167-811784654
PubMed ID
10371567 View in PubMed
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50bp deletion in the promoter for superoxide dismutase 1 (SOD1) reduces SOD1 expression in vitro and may correlate with increased age of onset of sporadic amyotrophic lateral sclerosis.

https://arctichealth.org/en/permalink/ahliterature156293
Source
Amyotroph Lateral Scler. 2008 Aug;9(4):229-37
Publication Type
Article
Date
Aug-2008
Author
Wendy J Broom
Matthew Greenway
Ghazaleh Sadri-Vakili
Carsten Russ
Kristen E Auwarter
Kelly E Glajch
Nicolas Dupre
Robert J Swingler
Shaun Purcell
Caroline Hayward
Peter C Sapp
Diane McKenna-Yasek
Paul N Valdmanis
Jean-Pierre Bouchard
Vincent Meininger
Betsy A Hosler
Jonathan D Glass
Meraida Polack
Guy A Rouleau
Jang-Ho J Cha
Orla Hardiman
Robert H Brown
Author Affiliation
Day Neuromuscular Research Laboratory, Massachusetts General Hospital, Charlestown, Massachusetts 02129, USA. wendy.broom@gmail.com
Source
Amyotroph Lateral Scler. 2008 Aug;9(4):229-37
Date
Aug-2008
Language
English
Publication Type
Article
Keywords
Age of Onset
Amyotrophic Lateral Sclerosis - enzymology - epidemiology - genetics
Base Sequence
DNA Mutational Analysis
Female
Gene Expression
Genetic Predisposition to Disease
Genotype
Homozygote
Humans
Ireland - epidemiology
Male
Middle Aged
Phenotype
Polymorphism, Genetic
Promoter Regions, Genetic
Quebec - epidemiology
Risk factors
Scotland - epidemiology
Sequence Deletion
Sp1 Transcription Factor - metabolism
Superoxide Dismutase - genetics - metabolism
United States - epidemiology
Abstract
The objective was to test the hypothesis that a described association between homozygosity for a 50bp deletion in the SOD1 promoter 1684bp upstream of the SOD1 ATG and an increased age of onset in SALS can be replicated in additional SALS and control sample sets from other populations. Our second objective was to examine whether this deletion attenuates expression of the SOD1 gene. Genomic DNA from more than 1200 SALS cases from Ireland, Scotland, Quebec and the USA was genotyped for the 50bp SOD1 promoter deletion. Reporter gene expression analysis, electrophoretic mobility shift assays and chromatin immunoprecipitation studies were utilized to examine the functional effects of the deletion. The genetic association for homozygosity for the promoter deletion with an increased age of symptom onset was confirmed overall in this further study (p=0.032), although it was only statistically significant in the Irish subset, and remained highly significant in the combined set of all cohorts (p=0.001). Functional studies demonstrated that this polymorphism reduces the activity of the SOD1 promoter by approximately 50%. In addition we revealed that the transcription factor SP1 binds within the 50bp deletion region in vitro and in vivo. Our findings suggest the hypothesis that this deletion reduces expression of the SOD1 gene and that levels of the SOD1 protein may modify the phenotype of SALS within selected populations.
PubMed ID
18608091 View in PubMed
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Abdominal symptoms and cancer in the abdomen: prospective cohort study in European primary care.

https://arctichealth.org/en/permalink/ahliterature303030
Source
Br J Gen Pract. 2018 05; 68(670):e301-e310
Publication Type
Journal Article
Date
05-2018
Author
Knut Holtedahl
Peter Hjertholm
Lars Borgquist
Gé A Donker
Frank Buntinx
David Weller
Tonje Braaten
Jörgen Månsson
Eva Lena Strandberg
Christine Campbell
Joke C Korevaar
Ranjan Parajuli
Author Affiliation
Department of Community Medicine, UiT The Arctic University of Norway, Norway.
Source
Br J Gen Pract. 2018 05; 68(670):e301-e310
Date
05-2018
Language
English
Publication Type
Journal Article
Keywords
Abdominal Neoplasms - diagnosis - epidemiology - pathology
Abdominal Pain - etiology - pathology
Adolescent
Adult
Aged
Aged, 80 and over
Belgium - epidemiology
Denmark - epidemiology
Early Detection of Cancer
Female
Gastrointestinal Hemorrhage - etiology - pathology
Hematuria - etiology - pathology
Humans
Male
Middle Aged
Netherlands - epidemiology
Norway - epidemiology
Primary Health Care
Prospective Studies
Referral and Consultation
Scotland - epidemiology
Sweden - epidemiology
Weight Loss
Young Adult
Abstract
Different abdominal symptoms may signal cancer, but their role is unclear.
To examine associations between abdominal symptoms and subsequent cancer diagnosed in the abdominal region.
Prospective cohort study comprising 493 GPs from surgeries in Norway, Denmark, Sweden, Scotland, Belgium, and the Netherlands.
Over a 10-day period, the GPs recorded consecutive consultations and noted: patients who presented with abdominal symptoms pre-specified on the registration form; additional data on non-specific symptoms; and features of the consultation. Eight months later, data on all cancer diagnoses among all study patients in the participating general practices were requested from the GPs.
Consultations with 61 802 patients were recorded and abdominal symptoms were documented in 6264 (10.1%) patients. Malignancy, both abdominal and non-abdominal, was subsequently diagnosed in 511 patients (0.8%). Among patients with a new cancer in the abdomen (n = 251), 175 (69.7%) were diagnosed within 180 days after consultation. In a multivariate model, the highest sex- and age-adjusted hazard ratio (HR) was for the single symptom of rectal bleeding (HR 19.1, 95% confidence interval = 8.7 to 41.7). Positive predictive values of >3% were found for macroscopic haematuria, rectal bleeding, and involuntary weight loss, with variations according to age and sex. The three symptoms relating to irregular bleeding had particularly high specificity in terms of colorectal, uterine, and bladder cancer.
A patient with undiagnosed cancer may present with symptoms or no symptoms. Irregular bleeding must always be explained. Abdominal pain occurs with all types of abdominal cancer and several symptoms may signal colorectal cancer. The findings are important as they influence how GPs think and act, and how they can contribute to an earlier diagnosis of cancer.
PubMed ID
29632003 View in PubMed
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Abdominal symptoms and cancer in the abdomen: prospective cohort study in European primary care.

https://arctichealth.org/en/permalink/ahliterature303215
Source
Br J Gen Pract. 2018 05; 68(670):e301-e310
Publication Type
Journal Article
Date
05-2018
Author
Knut Holtedahl
Peter Hjertholm
Lars Borgquist
Gé A Donker
Frank Buntinx
David Weller
Tonje Braaten
Jörgen Månsson
Eva Lena Strandberg
Christine Campbell
Joke C Korevaar
Ranjan Parajuli
Author Affiliation
Department of Community Medicine, UiT The Arctic University of Norway, Norway.
Source
Br J Gen Pract. 2018 05; 68(670):e301-e310
Date
05-2018
Language
English
Publication Type
Journal Article
Keywords
Abdominal Neoplasms - diagnosis - epidemiology - pathology
Abdominal Pain - etiology - pathology
Adolescent
Adult
Aged
Aged, 80 and over
Belgium - epidemiology
Denmark - epidemiology
Early Detection of Cancer
Female
Gastrointestinal Hemorrhage - etiology - pathology
Hematuria - etiology - pathology
Humans
Male
Middle Aged
Netherlands - epidemiology
Norway - epidemiology
Primary Health Care
Prospective Studies
Referral and Consultation
Scotland - epidemiology
Sweden - epidemiology
Weight Loss
Young Adult
Abstract
Different abdominal symptoms may signal cancer, but their role is unclear.
To examine associations between abdominal symptoms and subsequent cancer diagnosed in the abdominal region.
Prospective cohort study comprising 493 GPs from surgeries in Norway, Denmark, Sweden, Scotland, Belgium, and the Netherlands.
Over a 10-day period, the GPs recorded consecutive consultations and noted: patients who presented with abdominal symptoms pre-specified on the registration form; additional data on non-specific symptoms; and features of the consultation. Eight months later, data on all cancer diagnoses among all study patients in the participating general practices were requested from the GPs.
Consultations with 61 802 patients were recorded and abdominal symptoms were documented in 6264 (10.1%) patients. Malignancy, both abdominal and non-abdominal, was subsequently diagnosed in 511 patients (0.8%). Among patients with a new cancer in the abdomen (n = 251), 175 (69.7%) were diagnosed within 180 days after consultation. In a multivariate model, the highest sex- and age-adjusted hazard ratio (HR) was for the single symptom of rectal bleeding (HR 19.1, 95% confidence interval = 8.7 to 41.7). Positive predictive values of >3% were found for macroscopic haematuria, rectal bleeding, and involuntary weight loss, with variations according to age and sex. The three symptoms relating to irregular bleeding had particularly high specificity in terms of colorectal, uterine, and bladder cancer.
A patient with undiagnosed cancer may present with symptoms or no symptoms. Irregular bleeding must always be explained. Abdominal pain occurs with all types of abdominal cancer and several symptoms may signal colorectal cancer. The findings are important as they influence how GPs think and act, and how they can contribute to an earlier diagnosis of cancer.
PubMed ID
29632003 View in PubMed
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Accounting for Irish Catholic ill health in Scotland: a qualitative exploration of some links between 'religion', class and health.

https://arctichealth.org/en/permalink/ahliterature179028
Source
Sociol Health Illn. 2004 Jul;26(5):527-56
Publication Type
Article
Date
Jul-2004
Author
Patricia Walls
Rory Williams
Author Affiliation
MRC Social and Public Health Sciences Unit, University of Glasgow. WallsAMP@aol.com
Source
Sociol Health Illn. 2004 Jul;26(5):527-56
Date
Jul-2004
Language
English
Publication Type
Article
Keywords
Adult
Aged
Career Choice
Career Mobility
Catholicism - psychology
Emigration and Immigration - statistics & numerical data
Employment - psychology - statistics & numerical data
Female
Health status
Health Surveys
Humans
Ireland - ethnology
Male
Middle Aged
Minority Groups - education - psychology - statistics & numerical data
Motivation
Prejudice
Protestantism - psychology
Qualitative Research
Questionnaires
Residence Characteristics
Scotland - epidemiology
Social Class
Socioeconomic Factors
Urban Health - statistics & numerical data
Abstract
This paper considers the ways in which accounts from Glasgow Catholics diverge from those of Protestants and explores the reasons why people leave jobs, including health grounds. Accounts reveal experiences distinctive to Catholics, of health-threatening stress, obstacles to career progression within (mainly) private-sector organisations, and interactional difficulties which create particular problems for (mainly) middle class men. This narrows the employment options for upwardly mobile Catholics, who may then resort to self-employment or other similarly stressful options. The paper considers whether the competence of Catholics or Catholic cultural factors are implicated in thwarting social mobility among Catholics or, alternatively, whether institutional sectarianism is involved. We conclude that, of these options, theories of institutional sectarianism provide the hypothesis which currently best fits these data. In Glasgow, people of indigenous Irish descent are recognisable from their names and Catholic background and are identified as Catholic by others. Overt historical exclusion of Catholics from middle class employment options now seems to take unrecognised forms in routine assumptions and practices which restrict Catholic employment opportunities. It is argued that younger Catholics use education to overcome the obstacles to mobility faced by older people and circumvent exclusions by recourse to middle class public-sector employment. This paper aims to link historical, structural and sectarian patterns of employment experience to accounts of health and work, and in so doing to contribute to an explanation for the relatively poor health of Catholic Glaswegians with Irish roots.
PubMed ID
15283776 View in PubMed
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Adolescent smoking and family structure in Europe.

https://arctichealth.org/en/permalink/ahliterature31283
Source
Soc Sci Med. 2003 Jan;56(1):41-52
Publication Type
Article
Date
Jan-2003
Author
Dawn Griesbach
Amanda Amos
Candace Currie
Author Affiliation
Child and Adolescent Health Research Unit (CAHRU), Department of PE, Sport and Leisure Studies, University of Edinburgh, St. Leonard's Land, Holyrood Road, EH8 8AQ, Edinburgh, UK. dawn.griesbach@isd.csa.scot.nhs.uk
Source
Soc Sci Med. 2003 Jan;56(1):41-52
Date
Jan-2003
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Behavior - ethnology - psychology
Austria - epidemiology
Cross-Cultural Comparison
Denmark - epidemiology
Europe - epidemiology
Family - ethnology
Finland - epidemiology
Germany - epidemiology
Health Behavior - ethnology
Humans
Income
Norway - epidemiology
Prevalence
Research Support, Non-U.S. Gov't
Risk factors
Scotland - epidemiology
Smoking - ethnology
Social Change
Social Class
Wales - epidemiology
Abstract
This paper examines the relationship between family structure and smoking among 15-year-old adolescents in seven European countries. It also investigates the association between family structure and a number of known smoking risk factors including family socio-economic status, the adolescent's disposable income, parental smoking and the presence of other smokers in the adolescent's home. Findings are based on 1998 survey data from a cross-national study of health behaviours among children and adolescents. Family structure was found to be significantly associated with smoking among 15-year-olds in all countries, with smoking prevalence lowest among adolescents in intact families and highest among adolescents in stepfamilies. Multivariate analysis showed that several risk factors were associated with higher smoking prevalences in all countries, but that even after these other factors were taken into account, there was an increased likelihood of smoking among adolescents in stepfamilies. Further research is needed to determine the possible reasons for this association.
PubMed ID
12435550 View in PubMed
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Analysis of amyotrophic lateral sclerosis as a multistep process: a population-based modelling study.

https://arctichealth.org/en/permalink/ahliterature260423
Source
Lancet Neurol. 2014 Nov;13(11):1108-13
Publication Type
Article
Date
Nov-2014
Author
Ammar Al-Chalabi
Andrea Calvo
Adriano Chio
Shuna Colville
Cathy M Ellis
Orla Hardiman
Mark Heverin
Robin S Howard
Mark H B Huisman
Noa Keren
P Nigel Leigh
Letizia Mazzini
Gabriele Mora
Richard W Orrell
James Rooney
Kirsten M Scott
William J Scotton
Meinie Seelen
Christopher E Shaw
Katie S Sidle
Robert Swingler
Miho Tsuda
Jan H Veldink
Anne E Visser
Leonard H van den Berg
Neil Pearce
Source
Lancet Neurol. 2014 Nov;13(11):1108-13
Date
Nov-2014
Language
English
Publication Type
Article
Keywords
Adult
Aged
Amyotrophic Lateral Sclerosis - diagnosis - epidemiology
Disease Progression
England - epidemiology
Female
Finland - epidemiology
Humans
Ireland - epidemiology
Italy - epidemiology
Linear Models
Male
Middle Aged
Models, Theoretical
Population Surveillance - methods
Registries - statistics & numerical data
Scotland - epidemiology
Abstract
Amyotrophic lateral sclerosis shares characteristics with some cancers, such as onset being more common in later life, progression usually being rapid, the disease affecting a particular cell type, and showing complex inheritance. We used a model originally applied to cancer epidemiology to investigate the hypothesis that amyotrophic lateral sclerosis is a multistep process.
We generated incidence data by age and sex from amyotrophic lateral sclerosis population registers in Ireland (registration dates 1995-2012), the Netherlands (2006-12), Italy (1995-2004), Scotland (1989-98), and England (2002-09), and calculated age and sex-adjusted incidences for each register. We regressed the log of age-specific incidence against the log of age with least squares regression. We did the analyses within each register, and also did a combined analysis, adjusting for register.
We identified 6274 cases of amyotrophic lateral sclerosis from a catchment population of about 34 million people. We noted a linear relationship between log incidence and log age in all five registers: England r(2)=0·95, Ireland r(2)=0·99, Italy r(2)=0·95, the Netherlands r(2)=0·99, and Scotland r(2)=0·97; overall r(2)=0·99. All five registers gave similar estimates of the linear slope ranging from 4·5 to 5·1, with overlapping confidence intervals. The combination of all five registers gave an overall slope of 4·8 (95% CI 4·5-5·0), with similar estimates for men (4·6, 4·3-4·9) and women (5·0, 4·5-5·5).
A linear relationship between the log incidence and log age of onset of amyotrophic lateral sclerosis is consistent with a multistage model of disease. The slope estimate suggests that amyotrophic lateral sclerosis is a six-step process. Identification of these steps could lead to preventive and therapeutic avenues.
UK Medical Research Council; UK Economic and Social Research Council; Ireland Health Research Board; The Netherlands Organisation for Health Research and Development (ZonMw); the Ministry of Health and Ministry of Education, University, and Research in Italy; the Motor Neurone Disease Association of England, Wales, and Northern Ireland; and the European Commission (Seventh Framework Programme).
Notes
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Comment In: Lancet Neurol. 2014 Nov;13(11):1067-825300935
PubMed ID
25300936 View in PubMed
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An international invasive meningococcal disease outbreak due to a novel and rapidly expanding serogroup W strain, Scotland and Sweden, July to August 2015.

https://arctichealth.org/en/permalink/ahliterature281859
Source
Euro Surveill. 2016 Nov 10;21(45)
Publication Type
Article
Date
Nov-10-2016
Author
Jay Lucidarme
Kevin J Scott
Roisin Ure
Andrew Smith
Diane Lindsay
Bianca Stenmark
Susanne Jacobsson
Hans Fredlund
J Claire Cameron
Alison Smith-Palmer
Jim McMenamin
Steve J Gray
Helen Campbell
Shamez Ladhani
Jamie Findlow
Paula Mölling
Ray Borrow
Source
Euro Surveill. 2016 Nov 10;21(45)
Date
Nov-10-2016
Language
English
Publication Type
Article
Keywords
Bacterial Typing Techniques
Disease Outbreaks
Genes, Bacterial
Genome, Viral
Genotype
Global health
Humans
Meningococcal Infections - epidemiology - microbiology
Molecular Epidemiology
Neisseria meningitidis, Serogroup W-135 - classification - genetics - isolation & purification - pathogenicity
Phylogeny
Scotland - epidemiology
Serogroup
Serotyping
Sweden - epidemiology
Travel
Virulence - genetics
Abstract
The 23rd World Scout Jamboree in 2015 took place in Japan and included over 33,000 scouts from 162 countries. Within nine days of the meeting ending, six cases of laboratory-confirmed invasive serogroup W meningococcal disease occurred among scouts and their close contacts in Scotland and Sweden. The isolates responsible were identical to one-another by routine typing and, where known (4 isolates), belonged to the ST-11 clonal complex (cc11) which is associated with large outbreaks and high case fatality rates. Recent studies have demonstrated the need for high-resolution genomic typing schemes to assign serogroup W cc11 isolates to several distinct strains circulating globally over the past two decades. Here we used such schemes to confirm that the Jamboree-associated cases constituted a genuine outbreak and that this was due to a novel and rapidly expanding strain descended from the strain that has recently expanded in South America and the United Kingdom. We also identify the genetic differences that define the novel strain including four point mutations and three putative recombination events involving the horizontal exchange of 17, six and two genes, respectively. Noteworthy outcomes of these changes were antigenic shifts and the disruption of a transcriptional regulator.
Notes
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PubMed ID
27918265 View in PubMed
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An international study of hospital readmissions and related utilization in Europe and the USA.

https://arctichealth.org/en/permalink/ahliterature189481
Source
Health Policy. 2002 Sep;61(3):269-78
Publication Type
Article
Date
Sep-2002
Author
Gert P Westert
Ronald J Lagoe
Ilmo Keskimäki
Alastair Leyland
Mark Murphy
Author Affiliation
National Institute of Public Health and the Environment, RIVM (CZO), PO Box 1, 3720 BA Bilthoven, The Netherlands. gert.westert@rivm.nl
Source
Health Policy. 2002 Sep;61(3):269-78
Date
Sep-2002
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Arthroplasty, Replacement, Hip - utilization
Asthma - epidemiology - therapy
Diabetes Mellitus - epidemiology - therapy
Diagnosis-Related Groups - classification
Female
Finland - epidemiology
Health Services Research
Heart Failure - epidemiology - therapy
Humans
Length of Stay - statistics & numerical data
Male
Middle Aged
Netherlands - epidemiology
Outcome Assessment (Health Care) - methods
Patient Readmission - statistics & numerical data - trends
Pulmonary Disease, Chronic Obstructive - epidemiology - therapy
Quality Indicators, Health Care
Scotland - epidemiology
Stroke - epidemiology - therapy
United States - epidemiology
Utilization Review
Abstract
This study concerns a comparative analysis of hospital readmission rates and related utilization in six areas, including three European countries (Finland, Scotland and the Netherlands) and three states in the USA (New York, California, Washington State). It includes a data analysis on six major causes of hospitalization across these areas. Its main focus is on two questions. (1) Do hospital readmission rates vary among the causes of hospitalization and the study populations? (2) Are hospital inpatient lengths of stay inversely related to readmissions rates? The study demonstrated that diagnoses such as chronic obstructive pulmonary disease (COPD) and congestive heart failure (CHF) were the major causes of hospital readmission rates. The data showed that (initial) hospital stays were generally longer for patients who were readmitted than for those who were not. As a result, short stays were not associated with a higher risk of readmission, meaning that hospital readmissions were not produced by premature hospital discharges in the study population. Furthermore, the spatial variation in readmission rates within 7 versus 8-30 days showed to be identical. Finally, it was found that countries or states with relatively shorter stays showed higher readmission rates and vice versa. Since patients with readmissions in all of the areas had on average longer initial stays, this finding at country level does illustrate that there seems to be a country specific trade off between length of stay and rate of readmission. An explanation should be sought in differences in health care arrangements per area, including factors that determine length of stay levels and readmission rates in individual countries (e.g. managed care penetration, after care by GP's or home care).
PubMed ID
12098520 View in PubMed
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96 records – page 1 of 10.