EMİNE ÇETİN ASLAN, İSMAİL AĞIRBAŞ

Hastane Tekrar Yatışlarının Önemi, Türleri ve Risk Faktörleri

Son dönemde, sağlık politikalarının önemli bir bölümünü hastane tekrar yatışlarının azaltılması çabaları oluşturmaktadır. Bunun en önemli nedeni, tekrar yatışları azaltmak yoluyla sağlık harcamalarının düşürülmesi ve bakım kalitesi ve verimliliğinin artırılması gibi önemli amaçlara, eş zamanlı olarak ulaşılabilmesidir. Tekrar yatışlar, hastaya ait özellikler, hastaya verilen bakımın yetersizliği, sağlık sistemi özellikleri ve benzeri bir dizi farklı etkenin bir araya gelmesiyle oluşan; karmaşık bir olgudur. Her bir etken, incelenen hastalık ya da işlem türü, zaman dilimi ve araştırmanın yapıldığı popülasyona göre tekrar yatış oranına farklı etki etmektedir. Olgu, hangi nedene bağlı olarak ortaya çıkmış olursa olsun, sık görülen, maliyetli ve olumsuz bir sağlık çıktısıdır. Fakat hastaya ilave riskler ve sıkıntı getirmesi, ödeyiciler için harcamaları artırması, sağlık sistemi ve hizmet sunucular için düşük hizmet kalitesi ve verimsizlik bu nedenlerin en başta gelenleridir. Tüm olumsuz etkilerine rağmen tekrar yatışların tamamen ortadan kaldırılması mümkün değildir. Bununla birlikte böyle bir yaklaşım mantıksal olarak da yanlıştır. Bu bağlamda, tekrar yatışların azaltılmasına yönelik politikaların başarılı olabilmesi için, öncelikle, tekrar yatışlara neden olan etkenlerin ve tekrar yatış türlerinin belirlenmesi gerekmektedir.

The Importance, Types and Risk Factors of Hospital Readmission

Recently, the efforts about reducing hospital readmissions constitute a significant proportion of health policies. The most important reason for this is the simultaneous attainment of important objectives such as reduction of healthcare expenditures and improving the quality and efficiency of care, by reducing readmissions. Readmission is a complicated case that consists of a range of different factors like patient characteristics, inadequate care of the patient, health system characteristics and et cetera. Each factor has a different effect on the rate of readmission according to the type of disease or process being studied, the time frame, and the population of the study. The case is common, costly and unfavorable health outcome, no matter what the cause is. But, additional risks and distress for the patient, increased expenditures for the payers, poor quality of service for the health care system and service providers and inefficiency are in the lead of these reasons. Despite all the adverse effects, it is not possible to completely remove the readmissions. However, such an approach is logically misleading too. In this context, primarily, it is necessary to identify the factors that cause readmissions and the types of readmissions, in order to success of the policies that reduce the readmissions to hospital.

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