Potentially preventable hospitalisations in rural community-dwelling patients

Intern Med J. 2023 Feb;53(2):228-235. doi: 10.1111/imj.15545. Epub 2022 Aug 1.

Abstract

Background: Potentially preventable hospitalisations (PPH) are a common occurrence. Knowing the factors associated with PPH may allow high-risk patients to be identified and healthcare resources to be better allocated, and these factors may differ between urban and rural locations.

Aim: To determine factors associated with PPH in an Australian rural population.

Methods: A retrospective review of admitted patients' demographic and clinical data was used to describe and model the factors associated with PPH, using an age- and sex-matched control group of non-admitted patients. This study is based in a multi-site rural general practice, Tasmania. The study included patients aged ≥18 years residing in the Huon-Bruny Island region of Tasmania, who were active patients at a rural general practice and were admitted to a public hospital for a PPH between 1 July 2016 and 30 June 2019. Main outcome measure is overnight admission to hospital for a PPH.

Results: Predictors with a significant odds ratio (OR) in the final model were being single/unmarried (OR 2.43; 95% confidence interval (CI) 1.38-4.28), higher Charlson Comorbidity Index score (OR 1.40; 95% CI 1.13-1.74) and the number of general practice visits in the preceding 12 months (OR 1.09; 95% CI 1.05-1.14).

Conclusions: This study found that being single and having a higher comorbidity burden were the strongest independent risk factors for PPH in a rural population. Demographic and socioeconomic factors appeared to be as, if not more, important than medical factors and warrant attention when considering the design of programmes to reduce PPH risk in rural communities.

Keywords: general practice; potentially preventable hospitalisation; risk factor; rural health; social determinant of health.

MeSH terms

  • Adolescent
  • Adult
  • Australia
  • Hospitalization
  • Humans
  • Independent Living*
  • Rural Population*
  • Tasmania