{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:15:37Z","timestamp":1747196137231,"version":"3.40.5"},"reference-count":41,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2021,7,22]],"date-time":"2021-07-22T00:00:00Z","timestamp":1626912000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Aims<\/jats:title><jats:p>Assess trends and factors associated with interhospital transfers (IHT) and 30-day acute coronary syndrome (ACS) rehospitalizations in a national administrative database of patients admitted with an ACS between 2000\u20132015.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods and results<\/jats:title><jats:p>Cohort study of patients hospitalized with ACS from 2000 to 2015, using a validated linkage algorithm to identify and link patient-level sequential hospitalizations occurring within 30 days from first admission (considering all hospitalizations within the 30-day timeframe as belonging to the same ACS episode of care-ACS-EC). From 212,481 ACS-EC, 42,670 (20.1%) had more than one hospitalization. ACS-EC hospitalization rates decreased throughout the study period (2000: 207.7\/100.000 person-years to 2015: 185,8\/100,000 person-years, p for trend &lt;0.05). Proportion of IHT increased from 10.5% in 2000 to 20.1% in 2015 compared to a reduction in both planned and unplanned 30-day ACS rehospitalization from 9.0% in 2000 to 2.7% in 2015. After adjusting for patient and first admission hospital\u2019s characteristics, compared to 2000\u20132003, in 2012\u20132015 the odds of IHT increased by 3.81 (95%CI: 3.65\u20133.98); the odds of unplanned and planned 30-day ACS rehospitalization decreased by 0.36 (95%CI: 0.33; 0.39) and 0.47 (95%CI: 0.43; 0.53), respectively. Female sex, older age and the presence and severity of comorbidities were associated with lower likelihood of being transferred or having a planned 30-day ACS rehospitalization. Unplanned 30-day ACS rehospitalization was more likely in patients with higher comorbidity burden.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Conclusion<\/jats:title><jats:p>IHT and 30-day ACS rehospitalization reflect coronary referral network efficiency and access to specialized treatment. Identifying factors associated with higher likelihood of IHT and 30-day ACS rehospitalization may allow heightened surveillance and interventions to reduce rehospitalizations and inequities in access to specialized treatment.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0255134","type":"journal-article","created":{"date-parts":[[2021,7,22]],"date-time":"2021-07-22T17:54:49Z","timestamp":1626976489000},"page":"e0255134","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Time-trends and predictors of interhospital transfers and 30-day rehospitalizations after acute coronary syndrome from 2000-2015"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0824-4598","authenticated-orcid":true,"given":"J. Afonso","family":"Rocha","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9774-9864","authenticated-orcid":true,"given":"Jos\u00e9 Carlos","family":"Cardoso","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2113-9653","authenticated-orcid":true,"given":"Alberto","family":"Freitas","sequence":"additional","affiliation":[]},{"given":"Thomas G.","family":"Allison","sequence":"additional","affiliation":[]},{"given":"Lu\u00eds F.","family":"Azevedo","sequence":"additional","affiliation":[]}],"member":"340","published-online":{"date-parts":[[2021,7,22]]},"reference":[{"key":"pone.0255134.ref001","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/1471-2261-8-22","article-title":"Does interhospital transfer improve outcome of acute myocardial infarction? A propensity score analysis from the Cardiovascular Cooperative Project","volume":"8","author":"JM Westfall","year":"2008","journal-title":"BMC Cardiovasc Disord"},{"issue":"5","key":"pone.0255134.ref002","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1161\/CIRCOUTCOMES.108.832949","article-title":"Statistical models and patient predictors of readmission for acute myocardial infarction: a systematic review","volume":"2","author":"MM Desai","year":"2009","journal-title":"Circ Cardiovasc Qual Outcomes"},{"issue":"6","key":"pone.0255134.ref003","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1093\/eurheartj\/ehl535","article-title":"Long-term outcomes of patients with acute myocardial infarction presenting to hospitals without catheterization laboratory and randomized to immediate thrombolysis or interhospital transport for primary percutaneous coronary intervention. Five years\u2019 follow-up of the PRAGUE-2 Trial","volume":"28","author":"P Widimsky","year":"2007","journal-title":"Eur Heart J"},{"issue":"10","key":"pone.0255134.ref004","doi-asserted-by":"crossref","first-page":"823","DOI":"10.1053\/euhj.1999.1993","article-title":"Multicentre randomized trial comparing transport to primary angioplasty vs immediate thrombolysis vs combined strategy for patients with acute myocardial infarction presenting to a community hospital without a catheterization laboratory. The PRAGUE study","volume":"21","author":"P Widimsky","year":"2000","journal-title":"Eur Heart J"},{"issue":"7","key":"pone.0255134.ref005","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1016\/S0002-9343(02)01072-0","article-title":"Hospital transfer of patients with acute myocardial infarction: the effects of age, race, and insurance type","volume":"112","author":"JH Gurwitz","year":"2002","journal-title":"Am J Med"},{"issue":"14","key":"pone.0255134.ref006","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1056\/NEJMsa0803563","article-title":"Rehospitalizations among patients in the Medicare fee-for-service program","volume":"360","author":"SF Jencks","year":"2009","journal-title":"N Engl J Med"},{"issue":"18","key":"pone.0255134.ref007","doi-asserted-by":"crossref","first-page":"2231","DOI":"10.1016\/j.jacc.2018.08.1038","article-title":"Fourth Universal Definition of Myocardial Infarction (2018)","volume":"72","author":"K Thygesen","year":"2018","journal-title":"J Am Coll Cardiol"},{"issue":"10","key":"pone.0255134.ref008","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1002\/clc.23238","article-title":"The prevalence of 30-day readmission after acute myocardial infarction: A systematic review and meta-analysis","volume":"42","author":"H Wang","year":"2019","journal-title":"Clin Cardiol"},{"issue":"11","key":"pone.0255134.ref009","doi-asserted-by":"crossref","first-page":"e019226","DOI":"10.1136\/bmjopen-2017-019226","article-title":"Exploring the effects of transfers and readmissions on trends in population counts of hospital admissions for coronary heart disease: a Western Australian data linkage study","volume":"7","author":"D Lopez","year":"2017","journal-title":"BMJ Open"},{"issue":"7","key":"pone.0255134.ref010","first-page":"3","article-title":"Acute myocardial infarction hospitalization and treatment: Areas with a high percentage of First Nations identity residents","volume":"24","author":"HK Wei-Randall","year":"2013","journal-title":"Health Rep"},{"key":"pone.0255134.ref011","unstructured":"ACSS ACdSdS-. Condi\u00e7\u00f5es e procedimentos de pagamento das presta\u00e7\u00f5es de sa\u00fade realizadas aos benefici\u00e1rios do Servi\u00e7o Nacional de Sa\u00fade que devam ser cobradas pelas Institui\u00e7\u00f5es Hospitalares ao abrigo do Contrato-Programa 2019. 2019."},{"issue":"2","key":"pone.0255134.ref012","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1177\/107755878203900201","article-title":"Hospital case mix: its definition, measurement and use. Part II: Review of alternative measures","volume":"39","author":"MC Hornbrook","year":"1982","journal-title":"Med Care Rev"},{"issue":"11","key":"pone.0255134.ref013","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1097\/01.mlr.0000182534.19832.83","article-title":"Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data","volume":"43","author":"H Quan","year":"2005","journal-title":"Med Care"},{"issue":"23","key":"pone.0255134.ref014","doi-asserted-by":"crossref","first-page":"2155","DOI":"10.1056\/NEJMoa0908610","article-title":"Population trends in the incidence and outcomes of acute myocardial infarction","volume":"362","author":"RW Yeh","year":"2010","journal-title":"N Engl J Med"},{"issue":"12","key":"pone.0255134.ref015","doi-asserted-by":"crossref","first-page":"e033486","DOI":"10.1136\/bmjopen-2019-033486","article-title":"Internal deterministic record linkage using indirect identifiers for matching of same-patient hospital transfers and early readmissions after acute coronary syndrome in a nationwide hospital discharge database: a retrospective observational validation study","volume":"9","author":"A Rocha","year":"2019","journal-title":"BMJ Open"},{"issue":"29","key":"pone.0255134.ref016","doi-asserted-by":"crossref","first-page":"3670","DOI":"10.1002\/sim.3733","article-title":"Estimating average annual per cent change in trend analysis","volume":"28","author":"LX Clegg","year":"2009","journal-title":"Stat Med"},{"key":"pone.0255134.ref017","unstructured":"Matthews PAGJNS. Statistical Methods in Medical Research. 4th Edition ed2001."},{"journal-title":"Cancer registration: principles and methods. Statistical methods for registries","year":"1991","author":"BPP DM","key":"pone.0255134.ref018"},{"issue":"5","key":"pone.0255134.ref019","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1001\/jama.2011.72","article-title":"Hospital readmission as an accountability measure","volume":"305","author":"RN Axon","year":"2011","journal-title":"JAMA"},{"key":"pone.0255134.ref020","unstructured":"DGS. Rede de referencia\u00e7\u00e3o em Cardiologia. 2015."},{"key":"pone.0255134.ref021","unstructured":"CNDCV. Hemodin\u00e2mica Cardiologia de Interven\u00e7\u00e3o e Cirurgia Cardiotor\u00e1cica Indicadores de Actividades\u2013 2009. 2010."},{"key":"pone.0255134.ref022","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1002\/9781118548387.ch8","volume-title":"Applied Logistic Regression","author":"LS Hosmer DW","year":"2013"},{"issue":"9","key":"pone.0255134.ref023","doi-asserted-by":"crossref","first-page":"1186","DOI":"10.1007\/s00392-020-01612-1","article-title":"Temporal trends in incidence and outcome of acute coronary syndrome","volume":"109","author":"JT Neumann","year":"2020","journal-title":"Clin Res Cardiol"},{"issue":"1","key":"pone.0255134.ref024","doi-asserted-by":"crossref","first-page":"11","DOI":"10.7326\/0003-4819-157-1-201207030-00004","article-title":"Thirty-day rehospitalizations after acute myocardial infarction: a cohort study","volume":"157","author":"SM Dunlay","year":"2012","journal-title":"Ann Intern Med"},{"journal-title":"European Cardiovascular Disease Statistics Brussels","year":"2017","author":"WK Wilkins E WL","key":"pone.0255134.ref025"},{"issue":"3","key":"pone.0255134.ref026","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1016\/S0735-1097(00)00804-4","article-title":"Myocardial infarction redefined\u2014a consensus document of The Joint European Society of Cardiology\/American College of Cardiology Committee for the redefinition of myocardial infarction","volume":"36","author":"JS Alpert","year":"2000","journal-title":"J Am Coll Cardiol"},{"issue":"9","key":"pone.0255134.ref027","doi-asserted-by":"crossref","first-page":"858","DOI":"10.1056\/NEJMoa0900428","article-title":"Early diagnosis of myocardial infarction with sensitive cardiac troponin assays","volume":"361","author":"T Reichlin","year":"2009","journal-title":"N Engl J Med"},{"issue":"15","key":"pone.0255134.ref028","doi-asserted-by":"crossref","first-page":"1848","DOI":"10.1161\/CIRCULATIONAHA.111.047480","article-title":"Twenty-two-year trends in incidence of myocardial infarction, coronary heart disease mortality, and case fatality in 4 US communities, 1987\u20132008","volume":"125","author":"WD Rosamond","year":"2012","journal-title":"Circulation"},{"issue":"1","key":"pone.0255134.ref029","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1093\/eurheartj\/ehv317","article-title":"2015 ESC\/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS): Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC), International Society for Heart and Lung Transplantation (ISHLT)","volume":"37","author":"N Galie","year":"2016","journal-title":"Eur Heart J"},{"issue":"2","key":"pone.0255134.ref030","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1093\/eurheartj\/ehx393","article-title":"2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC)","volume":"39","author":"B Ibanez","year":"2018","journal-title":"Eur Heart J"},{"issue":"13","key":"pone.0255134.ref031","doi-asserted-by":"crossref","first-page":"1032","DOI":"10.1136\/heartjnl-2014-306966","article-title":"Long-term mortality following interhospital transfer for acute myocardial infarction","volume":"101","author":"I Ranasinghe","year":"2015","journal-title":"Heart"},{"issue":"5","key":"pone.0255134.ref032","doi-asserted-by":"crossref","first-page":"e005628","DOI":"10.1161\/CIRCOUTCOMES.119.005628","article-title":"Thirty-Day Hospital Readmission After Acute Myocardial Infarction in China","volume":"12","author":"J Li","year":"2019","journal-title":"Circ Cardiovasc Qual Outcomes"},{"issue":"19","key":"pone.0255134.ref033","doi-asserted-by":"crossref","first-page":"e012059","DOI":"10.1161\/JAHA.119.012059","article-title":"Readmissions After Acute Myocardial Infarction: How Often Do Patients Return to the Discharging Hospital?","volume":"8","author":"JA Rymer","year":"2019","journal-title":"J Am Heart Assoc"},{"issue":"2","key":"pone.0255134.ref034","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1161\/CIRCOUTCOMES.110.957498","article-title":"An administrative claims measure suitable for profiling hospital performance based on 30-day all-cause readmission rates among patients with acute myocardial infarction","volume":"4","author":"HM Krumholz","year":"2011","journal-title":"Circ Cardiovasc Qual Outcomes"},{"issue":"11","key":"pone.0255134.ref035","article-title":"Decade-Long Trends in 30-Day Rehospitalization Rates After Acute Myocardial Infarction","volume":"4","author":"HY Chen","year":"2015","journal-title":"J Am Heart Assoc"},{"issue":"4","key":"pone.0255134.ref036","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1001\/jama.2012.216476","article-title":"Diagnoses and timing of 30-day readmissions after hospitalization for heart failure, acute myocardial infarction, or pneumonia","volume":"309","author":"K Dharmarajan","year":"2013","journal-title":"JAMA"},{"issue":"1","key":"pone.0255134.ref037","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1001\/jama.2011.1926","article-title":"International variation in and factors associated with hospital readmission after myocardial infarction","volume":"307","author":"RD Kociol","year":"2012","journal-title":"JAMA"},{"issue":"13","key":"pone.0255134.ref038","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1136\/heartjnl-2015-307508","article-title":"Acute myocardial infarction and inter-hospital transfer","volume":"101","author":"CP Gale","year":"2015","journal-title":"Heart"},{"issue":"3","key":"pone.0255134.ref039","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1034\/j.1600-0854.2003.8047.x","article-title":"Acute myocardial infarction complicated by early onset of heart failure: safety and feasibility of interhospital transfer for coronary angioplasty. Subanalysis of Killip II-IV patients from the PRAGUE-1 study","volume":"16","author":"F Bednar","year":"2003","journal-title":"J Interv Cardiol"},{"issue":"1","key":"pone.0255134.ref040","first-page":"28","article-title":"Health records as the basis of clinical coding: Is the quality adequate? A qualitative study of medical coders\u2019 perceptions","volume":"49","author":"V Alonso","year":"2020","journal-title":"Health Inf Manag"},{"issue":"7","key":"pone.0255134.ref041","doi-asserted-by":"crossref","first-page":"1571","DOI":"10.1016\/j.burns.2018.09.013","article-title":"Quality of coding within clinical datasets: A case-study using burn-related hospitalizations","volume":"45","author":"J Souza","year":"2019","journal-title":"Burns"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0255134","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T06:18:08Z","timestamp":1672899488000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0255134"}},"subtitle":[],"editor":[{"given":"Chiara","family":"Lazzeri","sequence":"first","affiliation":[]}],"short-title":[],"issued":{"date-parts":[[2021,7,22]]},"references-count":41,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2021,7,22]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0255134","relation":{},"ISSN":["1932-6203"],"issn-type":[{"type":"electronic","value":"1932-6203"}],"subject":[],"published":{"date-parts":[[2021,7,22]]}}}