Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Apr 1:15:129.
doi: 10.1186/s12913-015-0807-2.

Geographical variation analysis of all-cause hospital readmission cases in Winnipeg, Canada

Yang Cui  1   2   3 , Mahmoud Torabi  4 , Evelyn L Forget  5 , Colleen Metge  6   7   8 , Xibiao Ye  9   10   11 , Michael Moffatt  12   13   14 , Luis Oppenheimer  15   16
Affiliations

Geographical variation analysis of all-cause hospital readmission cases in Winnipeg, Canada

Yang Cui et al. BMC Health Serv Res. .

Abstract

Background: Hospital readmission is costly and potentially avoidable. The concept of virtual wards as a new model of care is intended to reduce hospital readmissions by providing short-term transitional care to high-risk and complex patients in the community. In order to provide information regarding the development of virtual wards in the Winnipeg Health Region, Canada, this study used spatial statistics to identify geographic variations of hospital readmissions in 25 neighborhood clusters.

Methods: The data were obtained from the Population Health Research Data Repository housed at the Manitoba Centre for Health Policy. We used a Bayesian Disease Mapping approach which applied Markov chain Monte Carlo (MCMC) for cluster detection.

Results: Between 2005/06 and 2008/09, 123,842 patients were hospitalized in all Winnipeg hospitals. Of these, 41,551 (33%) were readmitted to hospital in the year following discharge. Most of these readmitted patients (89.4%) had 1-2 readmissions, while 11.6% of readmitted patients had more than 2 readmissions after initial discharge. The smoothed age- and sex- adjusted relative risk rates of hospital readmission in 25 Winnipeg neighborhood clusters ranged between 0.73 and 1.27. We found that there were spatial cluster variations of hospital readmission across the Winnipeg Health Region. Seven neighborhood clusters are more likely to be significant potential clusters for hospital readmissions (p < .05), while six neighborhood clusters are less likely to be significant potential clusters.

Conclusions: This study provides the foundation and implementation guide for the Winnipeg Regional Health Authority virtual ward program. The findings will also help to improve long-term condition management in community settings and will help program planners to assure the efficient use of healthcare resources.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Smoothed age- and sex- adjusted relative risk rate of readmission in 25 Winnipeg neighborhood clusters.
See this image and copyright information in PMC

References

    1. Monette M. Hospital readmission rates under the microscope. CMAJ. 2012;184(12):E651–2. doi: 10.1503/cmaj.109-4245. - DOI - PMC - PubMed
    1. Canadian Institute for Health Information. All-cause readmission to acute care and return to the emergency department. [https://secure.cihi.ca/free_products/Readmission_to_acutecare_en.pdf]
    1. Minott J. Reducing hospital readmissions. [http://www.academyhealth.org/files/publications/Reducing_Hospital_Readmi...]
    1. Foster D, Harkness G. Healthcare reform: pending changes to reimbursement for 30-day readmissions. [http://www.communitysolutions.com/assets/2012Institute_Presentations/aca...]
    1. Canadian Agency for Drugs and Technologies in Health. The use of virtual ward to reduce hospital readmissions in Canada. [http://www.cadth.ca/products/environmental-scanning/environmental-scans/...]