ABSTRACT
BACKGROUND: The high financial burden of avoidable hospitalizations has led to an increase of the study of hospitalizations for ambulatory care sensitive conditions (ACSC). There is limited information on the impact of secondary diagnoses on these hospitalizations, although patients' social and demographic characteristics, as well as the coexistence of multiple diseases are often identified in the literature as risk factors for avoidable hospitalizations. This study explores the impact of chronic conditions on the likelihood of hospitalizations for ACSC. METHODS: Data were extracted from the Portuguese hospital discharge database. Avoidable hospitalizations were identified according to the Canadian Institute for Healthcare Information, and chronic conditions were identified according to criteria set by the Agency for Healthcare Research and Quality. A retrospective study analysing all patients hospitalized for an ACSC and all patients hospitalized for non-ACSC was made, using multiple logistic regression models to identify the impact of chronic conditions on the risk of admission. RESULTS: The risk of an avoidable hospitalization increases by a factor of 1.35 (95 % CI [1.34;1.35]) for each additional chronic condition, and 1.55 (95 % CI [1.55;1.56]) for each additional body system affected. The respiratory and circulatory systems have the most impact on the risk of ACSC, increasing the risk by 8.72 (95 % CI [8.58;8.86]) and 3.01 (95 % CI [2.95;3.06]), respectively. CONCLUSIONS: The number of chronic conditions and the body systems affected increase the risk of hospital admissions for ACSC.
Subject(s)
Ambulatory Care , Chronic Disease , Comorbidity , Hospitalization , Patient Discharge , Adult , Aged , Ambulatory Care/economics , Canada , Databases, Factual , Delivery of Health Care , Ethnicity , Female , Hospitalization/economics , Humans , Logistic Models , Male , Middle Aged , Multiple Chronic Conditions , Portugal , Retrospective Studies , Risk FactorsABSTRACT
A light absorbing pi-conjugated oligomer-tetrafullerene nanoarray has been synthesized and its photophysical study reveals the presence of an intramolecular energy transfer. A phototovoltaic device fabricated from this nanoarray and poly(3-hexylthiophene) shows an external quantum efficiency of 15% at 500 nm.
ABSTRACT
Os autores tecem consideraçöes sobre as necessidades sanitárias da comunidade brasileira, enfatizando a Política Nacional de saúde, centrada na ATENÇAO PRIMARIA. Destacam, ainda, a abrangência dos programas e o posicionamento da enfermagem para a extensäo de cobertura. Estabelecem, otrossim, uma estratégia de açäo, apresentando propostas - alternativas para a implementaçäo de um plano de atuaçäo
