Systematic review of readmission risk predictor models

January 01, 0001

Systematic review of readmission risk predictor models

These US researchers sought to identify validated readmission risk prediction models and examine their performance. They searched MEDLINE, CINAHL, and the Cochrane Library along with searches of retrieved reference lists for prediction models tested and validated in patients. 7843 citations were identified, of which 30 studies (including 26 models) met inclusion criteria.

The researchers found: "The most common outcome used was 30-day readmission. Only 1 model specifically addressed preventable readmissions. Fourteen models that relied on retrospective administrative data could be potentially used to risk-adjust readmission rates for hospital comparison. Of these, 9 were tested in large US populations and had poor discriminative ability. Seven models could potentially be used to identify high-risk patients for intervention early during a hospitalization and 5 could be used at hospital discharge. Six studies compared different models in the same population and 2 of these found that functional and social variables improved model discrimination. Although most models incorporated variables for medical comorbidity and use of prior medical services, few examined variables associated with overall health and function, illness severity, or social determinants of health."

The researchers concluded: "Most current readmission risk prediction models that were designed for either comparative or clinical purposes perform poorly. Although in certain settings such models may prove useful, efforts to improve their performance are needed as use becomes more widespread."

Models to predict risk of readmission do not function well in their current forms


For the full abstract, click here.

JAMA 306(15):1688-1698, 19 October 2011 © 2011 American Medical Association
Risk Prediction Models for Hospital Readmission. Devan Kansagara, Honora Englander, Amanda Salanitro, et al.

Category: HSR. Health Services Research. Keywords: readmission, risk, predictor, model, validated, systematic review, journal watch.
Synopsis edited by Dr Paul Schaefer, Toledo, Ohio. Posted on Global Family Doctor 11 November 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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