Imperial College London
Alternate

Professor the Lord Darzi of Denham PC KBE FRS FMedSci HonFREng

Faculty of Medicine, Department of Surgery & Cancer

Co-Director of the IGHI, Professor of Surgery
 
 
 
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Contact

 

+44 (0)20 3312 1310a.darzi

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Rao:2019:10.1186/s12872-019-1057-8,
author = {Rao, A and Dani, K and Darzi, A and Aylin, P and Majeed, A and Bottle, R},
doi = {10.1186/s12872-019-1057-8},
journal = {BMC Cardiovascular Disorders},
title = {Regional variation in trajectories of long-term readmission rates among patients in England with heart failure},
url = {http://dx.doi.org/10.1186/s12872-019-1057-8},
volume = {19},
year = {2019}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundWe aimed to compare the characteristics and types of heart failure (HF) patients termed “high-impact users”, with high long-term readmission rates, in different regions in England. This will allow clinical factors to be identified in areas with potentially poor quality of care.MethodsPatients with a primary diagnosis of heart failure (HF) in the period 2008–2009 were identified using nationally representative primary care data linked to national hospital data and followed up for 5 years. Group-based trajectory models and sequence analysis were applied to their readmissions.ResultsIn each of the 8 NHS England regions, multiple discrete groups were identified. All the regions had high-impact users. The group with an initially high readmission rate followed by a rapid decline in the rate ranged from 2.5 to 11.3% across the regions. The group with constantly high readmission rate compared with other groups ranged from 1.9 to 12.1%. Covariates that were commonly found to have an association with high-impact users among most of the regions were chronic respiratory disease, chronic renal disease, stroke, anaemia, mood disorder, and cardiac arrhythmia. Respiratory tract infection, urinary infection, cardiopulmonary signs and symptoms and exacerbation of heart failure were common causes in the sequences of readmissions among high-impact users in all regions.ConclusionThere is regional variation in England in readmission and mortality rates and in the proportions of HF patients who are high-impact users.
AU  - Rao,A
AU  - Dani,K
AU  - Darzi,A
AU  - Aylin,P
AU  - Majeed,A
AU  - Bottle,R
DO  - 10.1186/s12872-019-1057-8
PY  - 2019///
SN  - 1471-2261
TI  - Regional variation in trajectories of long-term readmission rates among patients in England with heart failure
T2  - BMC Cardiovascular Disorders
UR  - http://dx.doi.org/10.1186/s12872-019-1057-8
UR  - http://hdl.handle.net/10044/1/69649
VL  - 19
ER  -
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