Are structural characteristics of programs and hospitals associated with 100-day readmission of hematopoietic SCTs in Taiwan?

摘要

Hematopoietic SCT (HSCT) is one treatment modality for hematological malignancies. It is increasingly common but remains centralized in certain hospitals wherein procedures and protocols can vary. This study examined 100-day readmission for patients with hematological malignancies undergoing HSCT in Taiwan from the years 2001 to 2006. Of particular interest was an examination of how HSCT program characteristics might influence outcomes. This population-based retrospective cohort study with longitudinal follow-up used Taiwan's National Health Insurance Research Database. A generalized linear model with a logistic-dependent variable representing being admitted or not admitted was used to model 100-day readmission, adjusting for the nested design. There were 718 HSCT recipients for hematological malignancies in the 5-year study period from 10 HSCT programs. In spite of the average length of stay of 43.71 days (s.d.=25.75) days, 52% of recipients were readmitted within 100 days of discharge. Ownership status, the number of HSCT hematologists, and the ratio of HSCT procedures to HSCT hematologists independently predicted 100-day readmission after adjusting for clustered data and controlling for recipient characteristics.