Anderson and Steinberg developed a model for predicting hospital readmissions in a patient receiving Medicare. The authors are from the Johns Hopkins University.
Patient selection: Medicare recipient being evaluated at the time of hospital discharge
Outcome: readmission to an acute care hospital within the next 60 days
Parameters from multivariate analysis:
(1) age in years
(2) gender
(3) race
(4) supplemental Medicaid coverage
(5) number of hospital discharges in the 60 days prior to current admission
(6) current admission for self-limited, non-chronic disease
(7) surgery performed during current admission
(8) reimbursement to the hospital in US dollars
(9) location of current hospital
(10) number of beds in current hospital
|
Parameter |
Finding |
Points |
|---|---|---|
|
gender |
female |
0 |
|
|
male |
1 |
|
race |
White |
0 |
|
|
non-White |
1 |
|
supplemental Medicaid coverage |
no |
0 |
|
|
yes |
1 |
|
reasons for current admission |
not self-limited or chronic |
0 |
|
|
self-limited, non-chronic |
1 |
|
surgery performed |
no |
0 |
|
|
yes |
1 |
|
location |
urban |
1 |
|
|
non-urban |
0 |
|
hospital beds |
>= 100 |
0 |
|
|
< 100 |
1 |
X =
= (-0.0048 * (age in years)) + (0.10908 * (points for gender)) - (0.14732 * (points for race)) + (0.21179 * (points for supplemental Medicaid)) + (0.46509 * (number of hospital discharges)) - (0.34245 * (current admission)) - (0.33536 * (surgery)) + (0.00005 * (reimbursement)) - (0.19647 * (points for hospital location)) + (0.16399 * (points for hospital size in beds)) - 0.1684
probability of hospital readmission to an acute care hospital within the next 60 days =
= 1 / (1 + EXP((-1)*X))
Limitations:
• Some variables like hospital reimbursment need to be adjusted for the interval change since 1985.
• The significance of bed size may have changed since 1985.
Purpose: To evaluate a Medicare beneficiary at the time of hospital discharge for risk of hospital readmission within the next 60 days.
Objective: risk factors, severity, prognosis, stage
ICD-10: ,
