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Scores Predict Readmission Likelihood

Cheryl Clark, for HealthLeaders Media, April 1, 2013

Executives at hospitals getting socked with readmissions penalties up to 3% of their Medicare reimbursement may dream of a formula that accurately predicts which patients will return within 30 days, and which of those they can prevent.

But a team from Brigham and Women's Hospital in Boston, collaborating with a team in Bern, Switzerland, is closer to making that dream come true for patients with medical illnesses, (but not for surgical patients).

Through a simple risk score, they say they can identify roughly one-fourth of a hospital's patient population with the highest likelihood of being readmitted, and then within that group the18% whose readmissions were potentially avoidable, for whom more expensive, intensive efforts might be worth the money.

Among 9,212 adult discharges from July 1, 2009 to June 30, 2010, and 2,398 readmissions, the researchers were able to prospectively identify 879, or 8.5% of all discharges, who were at high risk of a potentially avoidable readmission.

Jacques Donzé, MD, lead author of the report published in JAMA Internal Medicine, and colleagues wrote, "This easy-to-use model enables physicians to prospectively identify approximately 27% of the patients as high risk of having a potentially avoidable readmission." They added that it "would allow targeting intensive transitional care interventions to patients who might benefit the most."

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