title: Gender as risk factor for 30 days post-discharge hospital utilisation: a secondary data analysis.
abstract: OBJECTIVE
  In the 30 days after hospital discharge, hospital utilisation is common and costly. This study evaluated the association between gender and hospital utilisation within 30 days of discharge.
  
  
  METHODS
  Secondary data analysis using Poisson regression stratified by gender.
  
  
  METHODS
  737 English-speaking hospitalised adults from general medical service in urban, academic safety-net medical centre who participated in the Project Re-Engineered clinical trial (clinicaltrials.gov identifier: NCT00252057).
  
  
  METHODS
  The primary end point was hospital utilisation, defined as total emergency department visits and hospital readmissions within 30 days after index discharge.
  
  
  RESULTS
  Female subjects had a rate of 29 events for every 100 people and male subjects had a rate of 47 events for every 100 people (incident rate ratio (IRR) 1.62, 95% CI 1.28 to 2.06). Among men, risk factors included hospital utilisation in the 6 months prior to the index hospitalisation (IRR 3.55, 95% CI 2.38 to 5.29), being unmarried (IRR 1.72, 95% CI 1.12 to 2.64), having a positive depression screen (IRR 1.53, 95% CI 1.09 to 2.13) and no primary care physician (PCP) visit within 30 days (IRR 1.64, 95% CI 1.08 to 2.50). Among women, the only risk factor was hospital utilisation in the 6 months prior to the index hospitalisation (IRR 3.08, 95% CI 1.86 to 5.10).
  
  
  CONCLUSIONS
  In our data, male subjects had a higher rate of hospital utilisation within 30 days of discharge than female subjects. For men-but not for women-risk factors were being retired, unmarried, having depressive symptoms and having no PCP visit within 30 days. Interventions addressing these factors might lower hospital utilisation rates observed among men.
authors.affiliation: Department of Family Medicine, Boston University School of Medicine, Boston, Massachusetts, USA.
authors.forename: Shaula
authors.initials: S
authors.lastname: Woz
authors.forename: Suzanne
authors.initials: S
authors.lastname: Mitchell
authors.forename: Caroline
authors.initials: C
authors.lastname: Hesko
authors.forename: Michael
authors.initials: M
authors.lastname: Paasche-Orlow
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Greenwald
authors.forename: V K
authors.initials: VK
authors.lastname: Chetty
authors.forename: Julie
authors.initials: J
authors.lastname: O'Donnell
authors.forename: Brian
authors.initials: B
authors.lastname: Jack