Potentially avoidable hospitalizations in Switzerland between 1998 and 2018: rates, trends, determinants, and costs - PhDData

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Potentially avoidable hospitalizations in Switzerland between 1998 and 2018: rates, trends, determinants, and costs

The thesis was published by GOUVEIA COUTINHO BORGES, Alexandre, in January 2023, University of Lausanne.

Abstract:

Les hospitalisations potentiellement Ă©vitables (HPE) sont couramment utilisĂ©es comme indicateur de la qualitĂ© des soins de santĂ© et de la performance des soins primaires. Cependant, les donnĂ©es sont gĂ©nĂ©ralement prĂ©sentĂ©es dans un dĂ©lai restreint et pour une rĂ©gion spĂ©cifique, ce qui limite l’identification des tendances et des modèles nationaux. Dans cette Ă©tude, nous avons cherchĂ© Ă  calculer les taux, Ă  identifier les dĂ©terminants cliniques et Ă  estimer les coĂ»ts de HPE pour deux maladies pulmonaires frĂ©quentes (asthme et BPCO) en Suisse entre 1998 et 2018, en utilisant les donnĂ©es de sortie d’hĂ´pital disponibles pour les patients âgĂ©s de ≥20 ans. Les HTAP ont Ă©tĂ© dĂ©finies selon le projet Health Care Quality Indica- tors (HCQIP) de l’Organisation de coopĂ©ration et de dĂ©veloppement Ă©conomiques (OCDE). La rĂ©partition des HPE dans sept rĂ©gions administratives (LĂ©man, Mittelland, Nord-Ouest, Zurich, Est, Centre et Tessin) a Ă©tĂ© calculĂ©e, ainsi que le nombre total de journĂ©es d’hospitalisation associĂ©es aux HPE et les coĂ»ts estimĂ©s des groupes de diagnostic (DRG). Au total, 25’260 HPE pour l’asthme et 135’069 HPE pour la BPCO ont Ă©tĂ© identifiĂ©es au cours de la pĂ©riode de 20 ans. Les taux standardisĂ©s d’HPE pour 100’000 personnes pour l’asthme ont fluctuĂ© de 18,7 en 1998 Ă  22,5 en 2018. Les taux standardisĂ©s de HPE pour 100’000 personnes atteintes de BPCO ont presque doublĂ©, passant de 77,4 en 1998 Ă  142,7 en 2018. En 2018, les coĂ»ts totaux estimĂ©s de HPE s’Ă©levaient Ă  7,7 millions de francs suisses pour l’asthme et Ă  91,2 millions de francs suisses pour la BPCO. Nous concluons que les HPE pour l’asthme et la BPCO ont reprĂ©sentĂ© une charge et des coĂ»ts d’hospitalisation importants en Suisse.

Potentially avoidable hospitalizations (PAH) are commonly used as an indicator for health- care quality and primary care performance. However, data are usually presented in a restricted timeframe and for a specific region, limiting the identification of trends and national patterns. We aimed in this study to calculate rates, identify clinical determinants, and estimate costs of PAH for two frequent lung diseases (asthma and COPD) in Switzerland between 1998 and 2018 using hospital discharge data available for patients aged ≥20 years. PAH were defined according to the Health Care Quality Indicators Project (HCQIP) from the Organisation for Economic Co-operation and Development (OECD). The distribution of PAH in seven administrative regions (Leman, Mittelland, Northwest, Zurich, Eastern, Central, and Ticino) was calculated, along with PAH-associated total hospital days and Diagnosis-Related Group (DRG) estimated costs. Totals of 25,260 PAH for asthma and 135,069 PAH for COPD were identified in the 20-year period. The standardized rates of PAH per 100,000 people for asthma fluctuated from 18.7 in 1998 to 22.5 on 2018. The standardized rates of PAH per 100,000 people from COPD almost doubled from 77.4 in 1998 to 142.7 in 2018. In 2018, the estimated total costs of PAH amounted to 7.7 million CHF for asthma and 91.2 million CHF for COPD. We conclude that PAH for asthma and COPD represent a significant and unnecessary burden and costs of hospitalizations in Switzerland.

The full thesis can be downloaded at :
https://serval.unil.ch/notice/serval:BIB_84B85411B9E0


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