Background:Healthcare systems face escalating capacity challenges and patients with repeated acute admissions strain hospital resources disproportionately. However, studies investigating the characteristics of such patients across all public healthcare providers in a universal healthcare system are lacking.Objective:To investigate characteristics of patients with repeated acute admissions (three or more acute admissions within a calendar year) in regard to sociodemographic characteristics, disease burden, and contact with the primary healthcare sector.Methods:This matched register-based case–control study investigated repeated acute admissions from 1 January 2014 to 31 December 2018, among individuals, who resided in four Danish municipalities. The study included 6169 individuals with repeated acute admissions, matched 1:4 to individuals with no acute admissions and one to two acute admissions, respectively. Group comparisons were conducted using conditional logistic regression.Results:Receiving social benefits increased the odds of repeated acute admissions 9.5-fold compared with no acute admissions (odds ratio (OR) 9.5; 95% confidence interval (CI) 8.5; 10.6) and 3.4-fold compared with one to two acute admissions (OR 3.4; 95% CI 3.1; 3.7). The odds of repeated acute admissions increased with the number of used medications and chronic diseases. Having a mental illness increased the odds of repeated acute admissions 5.8-fold when compared with no acute admissions (OR 5.7; 95% CI 5.2; 6.4) and 2.3-fold compared with one to two acute admissions (OR 2.3; 95% CI 2.1; 2.5). Also, high use of primary sector services (e.g. nursing care) increased the odds of repeated acute admissions when compared with no acute admissions and one to two acute admissions.Conclusions:This study pinpointed key factors encompassing social status, disease burden, and healthcare utilisation as pivotal markers of risk for repeated acute admissions, thus identifying high-risk patients and facilitating targeted intervention.

中文翻译：

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反复急性入院的患者：社会人口学特征、疾病负担以及与初级卫生保健部门的接触——基于登记的回顾性病例对照研究

背景：医疗保健系统面临着不断升级的容量挑战，反复急性入院的患者对医院资源造成了不成比例的压力。然而，缺乏对全民医疗保健系统中所有公共医疗保健提供者的此类患者特征进行调查的研究。 目的：调查重复急性入院（一年内三次或多次急性入院）患者在社会人口学特征方面的特征，方法：这项基于登记的匹配病例对照研究调查了 2014 年 1 月 1 日至 2018 年 12 月 31 日期间重复急性入院的情况，调查对象为居住在丹麦四个城市的个人。该研究纳入了 6169 名反复急性入院的个体，分别与没有急性入院和 1 至 2 次急性入院的个体进行 1:4 匹配。使用条件逻辑回归进行组间比较。结果：与没有急性入院相比，接受社会福利使重复急性入院的几率增加了 9.5 倍（比值比 (OR) 9.5；95% 置信区间 (CI) 8.5；10.6）和 3.4与一到两次急性入院相比，增加了 3 倍（OR 3.4；95% CI 3.1；3.7）。随着所用药物和慢性病数量的增加，重复急性入院的几率也会增加。与无急性入院相比，患有精神疾病的重复急性入院几率增加了 5.8 倍（OR 5.7；95% CI 5.2；6.4），与一到两次急性入院相比增加了 2.3 倍（OR 2.3；95% CI 2.1） ；2.5）。此外，与无急性入院和一到两次急性入院相比，初级部门服务（例如护理）的大量使用增加了重复急性入院的几率。 结论：这项研究查明了包括社会地位、疾病负担和医疗保健利用在内的关键因素作为反复急性入院风险的关键标志物，从而识别高风险患者并促进有针对性的干预。