[Days in XXXX hospitals: who consumes most of them? A five-year record linkage study of "Heavy Users" in an Austrian province].

@entity1 @entity161 @entity146
OBJECTIVE: To find out whether the use of hospital days in all @entity146 inpatient services in the province of Lower Austria is equally distributed among @entity1 or whether subgroups with different intensity of hospital day use can be identified, and if so, how these subgroups can be characterized. METHODS: Data collected for administrative purposes for all three inpatient services of Lower Austria were analyzed for the years 1996 to 2000. Record Linkage allowed to identify @entity1 who had used several of these hospitals within the respective study periods. Cumulative hospital days per @entity1 were calculated for each of the years studied and the distribution of these cumulative hospital days was analyzed. RESULTS: Of the 202 996 hospital days accrued in the year 1996, 44.5 % were consumed by @entity1 who continuously stayed in hospital during the whole year ("static" population). In 2000 this percentage had dropped to 16.3 %; also the total number of hospital days had decreased by one third to 141 738. Of those @entity1 , who had at least once been admitted and/or discharged during a specific year ("dynamic population"), a stable proportion of around 17.0 % were responsible for 50.0 % of all hospital days. These @entity1 were more frequently of female sex, significantly younger, had more often repeated admissions and suffered more frequently from @entity161 than the rest of the group. CONCLUSIONS: The astonishing finding that, despite substantial change in the system of @entity146 care over five years, the percentage of @entity1 with high values for cumulative hospital days remains constant, warrants further analyses. In such analyses not only @entity1 and illness characteristics should be studied (which is suggested by the terms "heavy users" and "high utilizers"), but also factors such as the social context of the @entity1 , the existence or non-existence of community @entity146 services and their functioning, as well as existing or non-existing financial incentives for single services.
