Geographic disparities in hospital readmissions: a retrospective cohort study among patients with chronic disease in rural China

作者：Mingyue Li, Haoqing Tang, Huixian Zheng, Baisong Zhang, Haozhe Cheng, Yanshang Wang, Yuxun Zhou, Xiaotian Zhang, Pascal Geldsetzer, Xiaoyun Liu · 发表于：International Journal for Equity in Health · 年份：2025 · DOI：10.1186/s12939-025-02443-0 · 被引用次数：2 · 研究领域：Heart Failure Treatment and Management、Transplantation: Methods and Outcomes、Cardiovascular Function and Risk Factors

BACKGROUND: Frequent hospital readmissions place a significant burden on patients, families, and society. Many high-income countries have implemented financial incentives to reduce readmissions. In China, readmission metrics have also been introduced as part of the performance evaluation for secondary hospitals. However, the understanding of hospital readmissions, particularly in rural and remote areas of China, remains limited. This study aims to analyze geographic disparities in hospital readmissions among high-need patients. METHODS: This retrospective cohort study used anonymized hospital discharge data from January 1, 2017, to December 31, 2021, from three public secondary county hospitals. We included rural patients aged 15 and older with hypertension or type 2 diabetes. The outcomes were 30-day, 90-day, and annual readmissions. The explanatory variable was the travel distance to county hospitals, calculated based on the longitude and latitude of registered addresses. Covariates included patient demographics (gender, age, marital status, and ethnicity); health status (Charlson comorbidity score, types of chronic diseases, surgery, and length of stay); and other factors (health insurance and admitted departments). We first reported unweighted readmissions stratified by travel distances (< 40 km versus ≥ 40 km). Multiple logistic regression models were then used to examine the relationship between travel distances and readmissions. RESULTS: The 30-day, 90-day and annual r...