Skip to content Skip to navigation

Model Developed to Predict Readmission Risk

March 26, 2013
by Gabriel Perna
| Reprints

Researchers at Brigham and Women's Hospital (BWH) have developed a new model that could help clinicians identify which patients are at the greatest risk for avoidable readmissions. The model, which is based on three years of research, relies on seven variables that the researchers say are the strongest indicator of a patient who is at risk for readmission.

The factors, which the researchers say are available at the patient’s bedside prior to discharge, are as follows:

  • Hemoglobin level at discharge
  • Sodium level at discharge
  • Whether or not the patient is being discharged from an oncology service
  • Whether or not non-surgical patients had a procedure during their hospital stay
  • Whether or not the hospital admission was elective
  • The number of times the patient has been admitted to the hospital during the last year
  • The length of the patient's hospital stay

"The strength of this model is its simplicity," Jacques Donzé, M.D., MSc, a research associate in the Department of Medicine at BWH and co-creator of the model, said in a statement. "We have identified seven important variables that a physician can easily run through at a patient's bedside prior to discharge. If a patient is determined to be at high-risk for readmission, a return trip to the hospital could be prevented by providing additional interventions such as a home visit by a nurse or pharmacist consultation.

According to Jeffrey Schnipper, M.D., the director of clinical research for the BWH hospitalist service and a co-creator of the model, says identifying patients who at least have the potential to benefit from more intensive transitional interventions is the first step in reducing readmissions. The Centers for Medicare & Medicaid Services (CMS) have begun penalizing hospitals for high 30-day readmission rates.



Insurers to CBO: Consider Private Insurers’ Data in Evaluations of Telemedicine

Eleven private insurers, including Aetna, Humana and Anthem, are urging the Congressional Budget Office (CBO) to consider the experience of commercial insurers when evaluating the impact of telemedicine coverage in Medicare.

AHRQ Developing New Patient Safety Surveillance Tool

With the aim of improving patient safety monitoring, the Agency for Healthcare Research and Quality (AHRQ) within the U.S. Department of Health and Human Services (HHS) is currently developing and testing an improved patient safety surveillance system.

Gates Foundation Awards $210M to UW's Population Health Initiative

The Bill and Melinda Gates Foundation is awarding $210 million to Seattle-based University of Washington’s Population Health Initiative, with the funds going toward the construction of a new building to serve as the initiative’s hub.

AHA Offers Interoperability Standards Recommendations to ONC

The American Hospital Association (AHA) has offered feedback to the ONC on the agency’s draft Interoperability Standards Advisory (ISA) that it issued in August.

Survey: Healthcare Orgs Not Taking Mobile Security Seriously Enough

More than half (56 percent) of healthcare professionals believe their organization could be doing more to educate employees on HIPAA compliance and the rules around sharing protected health information.

Mount Sinai’s Research Arm Using Data Analytics to Address Health Inequities

The Arnhold Institute for Global Health at the Icahn School of Medicine at Mount Sinai is partnering with DigitalGlobe to create the Health Equity Atlas Initiative (ATLAS), a platform that standardizes and maps population data in order to generate insights that address health inequities.