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Distribution of the Indicator of the Appropriate Admission of Patients with Circulatory System Diseases to County Hospitals in Rural China: A Cross-Sectional Study

1,2,†, 1,2,†, 1,2,*, 1,2, 1,2, 1,2, 1,2, 1,2 and 1,2
1
School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
2
Hubei Provincial Department of Education, Key Research Institute of Humanities & Social Sciences, Research Centre for Rural Health Service, Wuhan 430030, China
*
Author to whom correspondence should be addressed.
These authors contributed equally to the development of this research study.
Int. J. Environ. Res. Public Health 2019, 16(9), 1621; https://doi.org/10.3390/ijerph16091621
Received: 16 April 2019 / Revised: 7 May 2019 / Accepted: 8 May 2019 / Published: 9 May 2019
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Abstract

Background: The inappropriate admission of patients with circulatory system diseases (CSDs) have contributed to the rapid increase in hospitalisation rates in China. The purpose of this study is to identify the key indicators of appropriate admission and their distribution by analysing CSD cases. Methods: A total of 794 records of inpatient CSD cases were collected from county hospitals in five counties in midwestern rural China through stratified random sampling and evaluated by using the Rural Appropriateness Evaluation Protocol (RAEP). RAEP has two parts: Indicator A, which represents requirement for services, and Indicator B, which represents diseases severity. Indicator distribution was analysed through frequency analysis. A three-level logistic regression model was used to examine the sociodemographic determinants of the positive indicators of appropriate CDSs admissions. Result: The inappropriate admission rate of CSDs was 33.4% and varied between counties. A2 (Varying dosage/drug under supervision, 58.22%), A8 (Stopping/continuing oxygen inhalation, 38.19%), A7 (Electrocardiogram per 2 hours, 34.22%), A3 (Calculation of intake and output volume, 31.19%) and B14 (Abnormal blood condition, 27.98%) were the top five positive indicators of CSDs. Indicator A (requirements for services) was more active than Indicator B (disease severity). The limitation of the role of Indicator B over time may be attributed to the different policies and environments of rural China and stimulated the increase in inappropriate admission rates. The results of three-level logistic regression suggested that the influence of gender, year, region and disease type on positive indicators should receive increased attention in the evaluation of CSDs admissions. Conclusion: This study found that A2, A8, A7, A3 and B14 were the key indicators and were helpful to determine the appropriate admission of CSDs in rural China. Managers may focus on these indicators, particularly the use of indicator A. View Full-Text
Keywords: inappropriate admission; circulatory system diseases; indicator distribution; county hospital; rural China inappropriate admission; circulatory system diseases; indicator distribution; county hospital; rural China
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Ye, Q.; Zhang, Y.; Gao, H.-X.; Chen, Y.-C.; Li, H.-M.; Zhang, H.; Hu, X.-M.; Lei, S.-H.; Jiang, D. Distribution of the Indicator of the Appropriate Admission of Patients with Circulatory System Diseases to County Hospitals in Rural China: A Cross-Sectional Study. Int. J. Environ. Res. Public Health 2019, 16, 1621.

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