Kadam, UT and Lawson, CA and Moody, DK and Teece, L and Uttley, J and Harvey, J and Iqbal, Z and Jones, PW (2017) Consumer segmentation and time interval between types of hospital admission: a clinical linkage database study. Journal of Public Health. 1 - 9. ISSN 1741-3850

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U Kadam - Consumer segmentation and time interval between types of hospital admission.pdf - Accepted Version
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Abstract

Background: Healthcare policies target unplanned hospital admissions and 30-day re-admission as key measures of efficiency, but do not focus on factors that influence trajectories of different types of admissions in the same patient over time. Objectives: To investigate the influence of consumer segmentation and patient factors on the time intervals between different types of hospital admission. Research design, subjects and measures: A cohort design was applied to an anonymised linkage database for adults aged 40 years and over (N = 58 857). Measures included Mosaic segmentation, multimorbidity defined on six chronic condition registers and hospital admissions over a 27-month time period. Results: The shortest mean time intervals between two consecutive planned admissions were: 90 years and over (160 days (95% confidence interval (CI): 146-175)), Mosaic groups 'Twilight subsistence' (171 days (164-179)) or 'Welfare borderline' and 'Municipal dependency' (177 days (172-182)) compared to the reference Mosaic groups (186 days (180-193)), and multimorbidity count of four or more (137 days (130-145)). Mosaic group 'Twilight subsistence' (rate ratio (RR) 1.22 (95% CI: 1.08-1.36)) or 'Welfare borderline' and 'Municipal dependency' RR 1.20 (1.10-1.31) were significantly associated with higher rate to an unplanned admission following a planned event. However, associations between patient factors and unplanned admissions were diminished by adjustment for planned admissions. Conclusion: Specific consumer segmentation and patient factors were associated with shorter time intervals between different types of admissions. The findings support innovation in public health approaches to prevent by a focus on long-term trajectories of hospital admissions, which include planned activity.

Item Type: Article
Additional Information: This is a pre-copyedited, author-produced version of an article accepted for publication in Journal of Public Health following peer review. The version of record Consumer segmentation and time interval between types of hospital admission: a clinical linkage database study is available online at: https://doi.org/10.1093/pubmed/fdx028.
Uncontrolled Keywords: chronic disease; social determinants; socioeconomics factors
Subjects: R Medicine > R Medicine (General)
R Medicine > RA Public aspects of medicine
?? chronic disease ??
?? social determinants ??
?? socioeconomics factors ??
Divisions: Faculty of Medicine and Health Sciences > Institute for Science and Technology in Medicine
Related URLs:
Depositing User: Symplectic
Date Deposited: 27 Apr 2017 14:44
Last Modified: 27 Apr 2017 14:44
URI: http://eprints.keele.ac.uk/id/eprint/3311

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