Hasan et al developed a model for predicting the risk of hospital readmission for a general medicine patient. This can help to identify a patient who may benefit from more aggressive management. The authors are from Brigham and Women's Hospital, Harvard University, University of Chicago, University of Toronto, University of Iowa, Iowa City VA Medical Center, University of California San Francisco and the University of Wisconsin.
Patient selection: general medicine
Outcome: 30-day readmission
arameters:
(1) insurance
(2) marital status
(3) regular physician
(4) Charlson comorbidity index (CCI)
(5) physical SF12 (mean in study 38)
(6) number of admissions in past year
(7) current hospital stay in days
|
Parameter |
Finding |
Points |
|
insurance |
medicare |
5 |
|
|
Medicaid |
4 |
|
|
self-pay |
4 |
|
|
private |
0 |
|
marital status |
currently married |
2 |
|
|
other |
0 |
|
regular physician |
no |
0 |
|
|
yes |
3 |
|
Charlson comorbidity index |
|
<CCI> |
|
physical SF12 |
|
-1 each 10 units |
|
admissions in past year |
0 |
0 |
|
|
1 to 3 |
4 |
|
|
4 |
9 |
|
|
>= 5 |
11 |
|
current hospital stay in days |
<= 2 days |
0 |
|
|
> 2 days |
3 |
where:
• Having a regular physician may indicate that the person needs to see a doctor often.
• The range for the SF12 is not stated. The paper states 0-100 SF12 physical and mental component scores.
total score =
= SUM(points for all 7 parameters)
Interpretation:
• minimum score: -5 (depending on physical SF12)
• maximum score: 30+ (depending on CCI)
• The higher the score the greater the risk of readmission.
|
Parameter |
Readmission Rate |
|
<= 6 |
< 9% |
|
7 to 17 |
10-19% |
|
18 to 24 |
20-29% |
|
>= 25 |
>= 30% |
Purpose: To estimate the risk of 30-day readmission for a general medicine patient being discharged from the hospital based on the model of Hasan et al.
Objective: risk factors, severity, prognosis, stage
ICD-10: ,
