901 Documentation of a Primary Care Physician Is Associated with Higher 90-day Burn Center Readmission
Notice bibliographique
Résumé
Abstract Introduction Burn survivors may require readmission after burn center discharge due to complications or for reconstruction. Primary care physicians (PCPs) may play an important role in the post-discharge care of burn patients, both in managing complications and facilitating burn center readmission when patient needs exceed community resources. The objective of this study was to assess the relationship between access to a community PCP and burn center readmission following initial discharge, hypothesizing that PCP access would be associated with a lower likelihood of readmission. Methods This retrospective cohort study included patients ≥ 15 years old admitted to a regional burn center from 2009–2023 who were alive at discharge. Variables were obtained from chart review and burn registry data. The exposure under study was the presence of a documented PCP in the inpatient record during initial burn center admission. The primary outcome was readmission to the same burn center for any reason within 90 days of discharge. We evaluated whether having a documented PCP during the initial burn-related admission was independently associated with likelihood of readmission using a multivariable logistic regression model adjusted for age, gender, total body surface area (TBSA) burned, inhalation injury, length of stay, operating room visits, complications, comorbidity, disability, smoking, and discharge disposition. Results Of 2,244 patients, 67% had a documented PCP and 5.6% were readmitted to the burn center within 90 days. Mean age was 46 years, 71% were male, and mean TBSA burned was 10%. Patients who were older, female, or had medical comorbidity were more likely to have a PCP documented. PCP documentation was independently associated with a greater likelihood of readmission (OR 1.61, 95% CI 1.05-2.47). More operating room visits or a major complication during the initial admission were also associated with higher likelihood of readmission. Conclusions Burn survivors with a documented PCP were more likely to be readmitted to the burn center within 90 days, suggesting that PCP access facilitates escalation of care for burn survivors in the community. As burn center care is highly centralized, PCPs may play an important role in triaging post-discharge complications in the outpatient setting and coordinating readmission to burn centers. These findings highlight the importance of PCP documentation during hospital admission to ensure that patients receive appropriate care after discharge. Applicability of Research to Practice The findings of this study can inform interventions that improve communication between inpatient burn clinicians and outpatient PCPs and can guide future studies examining post-discharge care pathways for burn survivors. Funding for the Study N/A
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,005 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,007 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».