Clinical profile of rural community hospital inpatients in Sweden – a register study

OBJECTIVE: Patients in Sweden’s rural community hospitals have not been clinically characterised. We compared characteristics of patients in general practitioner-led community hospitals in northern Sweden with those admitted to general hospitals. DESIGN: Retrospective register study. SETTING: Commun...

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Bibliographic Details
Published in:Scandinavian Journal of Primary Health Care
Main Authors: Hedman, Mante, Boman, Kurt, Brännström, Margareta, Wennberg, Patrik
Format: Text
Language:English
Published: Taylor & Francis 2021
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Online Access:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7971215/
http://www.ncbi.nlm.nih.gov/pubmed/33569976
https://doi.org/10.1080/02813432.2021.1882086
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Summary:OBJECTIVE: Patients in Sweden’s rural community hospitals have not been clinically characterised. We compared characteristics of patients in general practitioner-led community hospitals in northern Sweden with those admitted to general hospitals. DESIGN: Retrospective register study. SETTING: Community and general hospitals in Västerbotten and Norrbotten counties, Sweden. PATIENTS: Patients enrolled at community hospitals and hospitalised in community and general hospitals between 1 January 2010 and 31 December 2014. OUTCOME MEASURES: Age, sex, number of admissions, main, secondary and total number of diagnoses. RESULTS: We recorded 16,133 admissions to community hospitals and 60,704 admissions to general hospitals. Mean age was 76.8 and 61.2 years for community and general hospital patients (p < .001). Women were more likely than men to be admitted to a community hospital after age adjustment (odds ratio (OR): 1.11; 95% confidence interval (CI): 1.09–1.17). The most common diagnoses in community hospital were heart failure (6%) and pneumonia (5%). Patients with these diagnoses were more likely to be admitted to a community than a general hospital (OR: 2.36; 95% CI: 2.15–2.59; vs. OR: 3.32: 95% CI: 2.77–3.98, respectively, adjusted for age and sex). In both community and general hospitals, doctors assigned more diagnoses to men than to women (both p<.001). CONCLUSIONS: Patients at community hospitals were predominantly older and women, while men were assigned more diagnoses. The most common diagnoses were heart failure and pneumonia. Our observed differences should be further explored to define the optimal care for patients in community and general hospitals. KEY POINTS: The patient characteristics at Swedish general practitioner-led rural community hospitals have not yet been reported. This study characterises inpatients in community hospitals compared to those referred to general hospitals. • Patients at community hospitals were predominantly older, with various medical conditions that would have led to ...