The HOSPITAL Score: Potentially avoidable 30-day hospital readmissions

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This simple prediction model identifies before discharge the risk of potentially avoidable 30-day readmission in medical patients. This score has potential to easily identify patients who may need more intensive transitional care interventions.

The HOSPITAL Score is intended for:
-        patients of at least 18 years about to be discharged from hospitals

The HOSPITAL Score is not intended for:
-        use outside of medical services
-        for patients who are not about to be discharged from hospital
-        for patients who are hospitalized for observational stays

Research authors: Jacques Donzé , Drahomir Aujesky, Deborah Williams, Jeffrey L Schnipper

Version: 1.12

Public
Internal medicine
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V-1.12-1002.24.05.31

(01)08719327522752(8012)v1.12(4326)240531(240)1002

Download the User manual and consult the Intended purpose.

Details
Intended purpose
Electronic label
Release Notes
User manual
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The HOSPITAL score is:

Points

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The HOSPITAL score is: Points

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Conditional information

The HOSPITAL score identifies three risk categories:

Low risk group: 0 - 4 points.
Intermediate risk group: 5 - 6 points.
High risk group: ≥ 7 points.

PRO

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Calculations alone should never dictate patient care, and are no substitute for professional judgement. See our full disclaimer.

Underlying algorithms Part of

Additional information

Details

Algorithm author

Evidencio.Medical.Devices

Algorithm ID

10437

Version

1.12

Revision date

2024-05-31

Specialty

Internal medicine

Algorithm type

Linear regression ^{(Calculation)}

MeSH terms

Patient Readmission

Hospital Readmission

Status

Public

Formula
No Formula defined yet

Condition	Formula

Study characteristics

Additional information

This retrospective cohort study included consecutive adult patient discharges from all medical services of the Brigham and Women's Hospital with a discharge date between July 1, 2009, and June 30, 2010. Brigham and Women's Hospital is a 750-bed academic medical center in Boston, Massachusetts, with 44 000 inpatient admissions per year. Medical services include general medicine, cardiology, oncology, bone marrow transplant, endocrinology, gastroenterology, hematology, infectious diseases, rheumatology, and nephrology. To avoid inclusion of observation stays, only hospitalizations with a length of stay of more than 24 hours were included. Hospitalizations were excluded when the patient died before discharge, was transferred to another acute health care facility, or left against medical advice. The hospitalizations were randomized into a derivation set (two-thirds of admissions) and a validation set (one-third of admissions). The protocol was approved by the institutional review board of Brigham and Women's Hospital/Partners HealthCare.

Study Population

Total population size: 9212

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Categorical characteristics

Name	Subset / Group	Nr. of patients
Age	≤ 75 years	7161
Age	> 75 years	2051
Ethnicity	Non-Hispanic white	6655
Ethnicity	Non-hispanic black	1498
Ethnicity	Hispanic	773
Ethnicity	Other	286
First language	English	8376
First language	Spanish	482
First language	Other	354
Marital status	Current spouse or partner	4695
Marital status	Single/never married	2315
Marital status	Separated/divorced/widowed/no answer	2202
Primary insurance	Medicare	4676
Primary insurance	Medicaid	749
Primary insurance	Private	3775
Primary insurance	None	12
Source of index admission	Emergency department	4902
Source of index admission	Direct from home/outpatient clinic	2830
Source of index admission	Nursing home/rehabilitation facility/other hospital	1480
Type of index admission	Elective	1188
Type of index admission	Nonelective	8021
Division of index admission	Oncology	2192
Division of index admission	Other medical service	7020
Length of stay at index admission	1-4 days	5181
Length of stay at index admission	>4 days	4031
No. of hospital admissions in the past years	0	4321
No. of hospital admissions in the past years	1-5	4456
No. of hospital admissions in the past years	>5	435
Identified caregiver at discharge	No	662
Identified caregiver at discharge	Yes	8459
No. of medications at discharge	0 - 6	1863
No. of medications at discharge	7 - 9	2017
No. of medications at discharge	10 - 13	2503
No. of medications at discharge	>13	2829
No. of procedures during index admission	0	3636
No. of procedures during index admission	≥1	5576
Hemoglobin level at discharge	<12.0 g/dL	5626
Hemoglobin level at discharge	≥12.0 g/dL	3586
Serum sodium level at discharge	<135 mEq/L	1454
Serum sodium level at discharge	≥135 mEq/L	7758
GFR at discharge	<30 mL/min	892
GFR at discharge	30-59	1977
GFR at discharge	≥60	6343
Comorbidity	Diabetes mellitus	2312
Comorbidity	Ischemic heart disease	2497
Comorbidity (ct)	Heart failure	2029
Comorbidity (ct)	Atrial fibrillation	1633
Comorbidity (ct)	COPD	936
Comorbidity (ct)	Malignant neoplasm	3250

Supporting Publications

Title or description

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Extra Information

	Evidencio B.V., Irenesingel 19, 7481 GJ Haaksbergen, The Netherlands
	V-1.12-1002.24.05.31
	(01)08719327522752(8012)v1.12(4326)240531(240)1002
	Decomplix AG, Freiburgstrasse 3, 3010 Bern, Switzerland
	Download the User manual
	Medical device In vitro diagnostic medical device

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This algorithm has been certified as a medical device

V-1.12-1002.24.05.31

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The HOSPITAL score is: Points

Conditional information

Details

Study characteristics

Additional information

Study Population

Categorical characteristics

Supporting Publications

Related files

This algorithm has been certified as a medical device

This is a paid algorithm

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