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Predicting Avoidable 30-Day Readmissions

Predicting Avoidable 30-Day Readmissions

Throughout the United States, readmission rates are increasingly being used for benchmarking across hospitals. Some hospital readmissions may be avoidable, which in turn has led to the levying of financial penalties on hospitals with high risk-adjusted rates. Recent studies have estimated that the 30-day readmission rate for Medicare beneficiaries is almost 20%, and these occurrences cost the U.S. healthcare system as much as $17 billion annually. Several prediction scores have been developed, but few accurately and efficiently predict 30-day readmission risk in general medical patients, explains Jacques Donzé, MD, MSc. “The models that are currently available often do not distinguish between avoidable and unavoidable readmissions, have poor discriminatory power, or use complex scores that aren’t calculable before hospital discharge. Interventions to reduce readmissions are often expensive to implement. To improve efficiency, the highest intensity interventions should be targeted to patients who are most likely to benefit.” A New Prediction Model for 30-Day Readmission In JAMA Internal Medicine, Dr. Donzé and colleagues had a study published that derived and validated a prediction model for potentially avoidable 30-day hospital readmissions in medical patients. The model used administrative and clinical data that was readily available prior to discharge. “Our purpose was to help clinicians target transitional care interventions most efficiently,” Dr. Donzé says. “The goal was to develop a score to predict potentially avoidable readmissions. In other words, we wanted to predict which patients may be most likely to benefit from intensive interventions.” The HOSPITAL score is able to indicate readmission risk before a patient is discharged. This allows clinicians to target a timely transitional care intervention. In their retrospective analysis, Dr....
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