Applicability of a previously validated readmission predictive index in medical patients in Singapore: a retrospective study
نویسندگان
چکیده
BACKGROUND Hospital readmissions are serious and costly events, and readmission rates are considered to be an indicator of quality in health care management. Several models to identify patients at risk of unplanned readmissions have been developed in Western countries, but little is known about their performance in other countries. This paper reports the possible utility of one such model developed in Canada, the LACE index, in patients in a tertiary hospital in Singapore. METHODS We used administrative data from Singapore General Hospital for patients admitted between 1st January 2006 and 31st December 2010. Data such as demographic and clinical data including disease codes were extracted. The patient cohort was divided into two groups with a LACE index of 10 as the cutoff. Multivariate logistic regression analysis models were used to compare the outcomes between the two groups of patients with adjustment for age, sex, ethnicity, year of discharge, intensive care unit admission, and admission ward class. RESULTS Overall, 127 550 patients were eligible for analysis. Patients with a LACE index ≥ 10 had a higher risk of 30-day unplanned readmission after index discharge (odds ratio [OR]: 4.37; 95% confidence interval [CI]: 4.18-4.57). After adjustment, the risk remained significant (OR: 4.88; 95% CI: CI 4.57-5.22). The C-statistic for the adjusted model was 0.70 (P < 0.001). Similar results were shown for 90-day unplanned readmission and emergency visits after the same adjustment. CONCLUSION The use of the LACE index may have significant application in identifying medical patients at high risk of readmission and visits to the Emergency Department in Singapore.
منابع مشابه
Early unplanned readmission of elderly in Singapore: a retrospective study.
STUDY OBJECTIVE To study the incidence and profile of elderly patients requiring early unplanned readmission within 15 days of discharge from a regional hospital and the predictive factors for readmission. PATIENTS All patients (n = 150) aged 65 years old and above who were readmitted within 15 days into the hospital's geriatric unit in the western region of Singapore over a period of 10 mont...
متن کاملHousing as a Social Determinant of Health in Singapore and Its Association with Readmission Risk and Increased Utilization of Hospital Services
BACKGROUND Residence in public rental housing is an area-level measure of socioeconomic status, but its impact as a social determinant of health in Singapore has not been studied. We therefore aimed to examine the association of public rental housing with readmission risk and increased utilization of hospital services in Singapore. METHODS We conducted a retrospective cohort study using retro...
متن کاملFrequent hospital admissions in Singapore: clinical risk factors and impact of socioeconomic status.
INTRODUCTION Frequent admitters to hospitals are high-cost patients who strain finite healthcare resources. However, the exact risk factors for frequent admissions, which can be used to guide risk stratification and design effective interventions locally, remain unknown. Our study aimed to identify the clinical and sociodemographic risk factors associated with frequent hospital admissions in Si...
متن کاملThe Relationship Between Performance Indicators and Readmission of Patients With Open Heart Surgery: A Case Study in Iran
Background: Open heart surgery is a prevalent therapeutic intervention for cardiovascular diseases. Significant adverse effects occur after heart surgery, one of which is patient readmission to the hospital. Objective: The present study aimed to determine the relationship between performance indicators and the readmission of patients with open heart surge...
متن کاملPerformance of the LACE index to identify elderly patients at high risk for hospital readmission in Singapore
Unplanned readmissions may be avoided by accurate risk prediction and appropriate resources could be allocated to high risk patients. The Length of stay, Acuity of admission, Charlson comorbidity index, Emergency department visits in past six months (LACE) index was developed to predict hospital readmissions in Canada. In this study, we assessed the performance of the LACE index in a Singaporea...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 13 شماره
صفحات -
تاریخ انتشار 2013