Clinical profile of rural community hospital inpatients in Sweden – a register study

Abstract

Objective

Patients in Sweden’s rural community hospitals have not been clinically characterised. We compared characteristics of patients in general practitioner-led community hospitals in northern Sweden with those admitted to general hospitals.

Design

Retrospective register study.

Setting

Community and general hospitals in Västerbotten and Norrbotten counties, Sweden.

Patients

Patients enrolled at community hospitals and hospitalised in community and general hospitals between 1 January 2010 and 31 December 2014.

Outcome measures

Age, sex, number of admissions, main, secondary and total number of diagnoses.

Results

We recorded 16,133 admissions to community hospitals and 60,704 admissions to general hospitals. Mean age was 76.8 and 61.2 years for community and general hospital patients (p < .001). Women were more likely than men to be admitted to a community hospital after age adjustment (odds ratio (OR): 1.11; 95% confidence interval (CI): 1.09–1.17). The most common diagnoses in community hospital were heart failure (6%) and pneumonia (5%). Patients with these diagnoses were more likely to be admitted to a community than a general hospital (OR: 2.36; 95% CI: 2.15–2.59; vs. OR: 3.32: 95% CI: 2.77–3.98, respectively, adjusted for age and sex). In both community and general hospitals, doctors assigned more diagnoses to men than to women (both p<.001).

Conclusions

Patients at community hospitals were predominantly older and women, while men were assigned more diagnoses. The most common diagnoses were heart failure and pneumonia. Our observed differences should be further explored to define the optimal care for patients in community and general hospitals.

Key points

• The patient characteristics at Swedish general practitioner-led rural community hospitals have not yet been reported. This study characterises inpatients in community hospitals compared to those referred to general hospitals.

  • • Patients at community hospitals were predominantly older, with various medical conditions that would have led to a referral to general hospitals elsewhere in Sweden.

  • • Compared to men, women were more likely to be admitted to community hospitals than to general hospitals, even after adjustment for age. To the best of our knowledge, this pattern has not been reported in other countries with community hospitals.

  • • In both community hospitals and general hospitals, doctors assigned more diagnoses to men than to women.

Keywords:

• Rural health service
• health services research
• hospital
• rural
• inpatient
• health services for the aged
• geriatrics

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded by grants from Västerbotten County Council.