Predicting Early Hospital Readmission for a Cohort of Adult Inpatients Using the Probability of Repeated Admission (PRA) Instrument

2.50
Hdl Handle:
http://hdl.handle.net/10755/154348
Type:
Presentation
Title:
Predicting Early Hospital Readmission for a Cohort of Adult Inpatients Using the Probability of Repeated Admission (PRA) Instrument
Abstract:
Predicting Early Hospital Readmission for a Cohort of Adult Inpatients Using the Probability of Repeated Admission (PRA) Instrument
Conference Sponsor:Sigma Theta Tau International
Conference Year:2006
Author:Novotny, Nancy L., MS, RN
P.I. Institution Name:University of Illinois
Title:Clinical Associate in Nursing
Background:  Up to 25% of adults experience early readmission.  Pre-discharge identification of patients likely to be readmitted could help target interventions that reduce readmissions, costs, and exposures to hospital-associated risks.  The Pra score, a valid predictor of elderly hospital readmissions within 4 years, was used to estimate prediction of adults? readmission within 1 month. Method:  A cohort of internal medicine service adults in a Midwestern tertiary medical center with life expectancy > 6 months was interviewed and provided releases of information June-July 2005.  Before discharge trained assistants abstracted records and derived Pra scores using age, gender, admissions and doctor/clinic visits in the last year, subjective health status, caretaker availability, and diabetes or coronary artery disease (CAD). The 75th percentile was used to classify patients likely (= .48) versus unlikely (<.48) to be readmitted.  Local hospital records were queried for subjects? early readmissions.   Results: Of 156 consecutive patients, 35 were discharged before screened, while 60% (72/121) were eligible and consented. The sample was 56% (40/72) female; with median age of 53 (18 - 97), admissions = 1 (1 - 14), and doctor/clinic visits = 10 (0 - 100).  Caretaker available for 90% (67/72), 33% (24/72) had diabetes, and 18% (13/72) had CAD.  Health status was poor/fair 60%, good/very good 37%, and excellent 3%. Readmissions occurred with 11%.  Predictive values included: sensitivity 75% (6/8), 95% Confidence Interval (CI): 0.45 - 1.05; specificity 69% (44/64), CI: 0.57 - 0.80; positive predictive value 23% (6/26), CI: 0.07 - 0.39; negative predictive value 96% (44/46), CI: 0.88 - 1.04; and odds ratio 6.143, CI: 1.28 - 28.75. Conclusions:  Multi-institutional replication with larger samples is needed to confirm Pra?s ability.  Within this heterogeneous sample, readmission of high (vs low) Pra patients was 6 times more likely.  Pra?s promising predictive ability may add valuable discharge planning information.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePredicting Early Hospital Readmission for a Cohort of Adult Inpatients Using the Probability of Repeated Admission (PRA) Instrumenten_GB
dc.identifier.urihttp://hdl.handle.net/10755/154348-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Predicting Early Hospital Readmission for a Cohort of Adult Inpatients Using the Probability of Repeated Admission (PRA) Instrument</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2006</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Novotny, Nancy L., MS, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Illinois</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Associate in Nursing</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">tenten@uic.edu</td></tr><tr><td colspan="2" class="item-abstract">Background:&nbsp; Up to 25% of adults experience early readmission.&nbsp; Pre-discharge identification of patients likely to be readmitted could help target interventions that reduce readmissions, costs, and exposures to hospital-associated risks.&nbsp; The Pra score, a valid predictor of elderly hospital readmissions within 4 years, was used to estimate prediction of adults? readmission within 1 month.&nbsp;Method:&nbsp; A cohort of internal medicine service adults in a Midwestern tertiary medical center with life expectancy &gt; 6 months was interviewed and provided releases of information June-July 2005.&nbsp; Before discharge trained assistants abstracted records and derived Pra scores using age, gender, admissions and doctor/clinic visits in the last year, subjective health status, caretaker availability, and diabetes or coronary artery disease (CAD). The 75th percentile was used to classify patients likely (= .48) versus unlikely (&lt;.48) to be readmitted.&nbsp; Local hospital records were queried for subjects? early readmissions.&nbsp; &nbsp;Results: Of 156 consecutive patients, 35 were discharged before screened, while 60% (72/121) were eligible and consented. The sample was 56% (40/72) female; with median age of 53 (18 - 97), admissions = 1 (1 - 14), and doctor/clinic visits = 10 (0 - 100).&nbsp; Caretaker available for 90% (67/72), 33% (24/72) had diabetes, and 18% (13/72) had CAD.&nbsp; Health status was poor/fair 60%, good/very good 37%, and excellent 3%. Readmissions occurred with 11%.&nbsp; Predictive values included: sensitivity 75% (6/8), 95% Confidence Interval (CI): 0.45 - 1.05; specificity 69% (44/64), CI: 0.57 - 0.80; positive predictive value 23% (6/26), CI: 0.07 - 0.39; negative predictive value 96% (44/46), CI: 0.88 - 1.04; and odds ratio 6.143, CI: 1.28 - 28.75.&nbsp;Conclusions:&nbsp; Multi-institutional replication with larger samples is needed to confirm Pra?s ability.&nbsp; Within this heterogeneous sample, readmission of high (vs low) Pra patients was 6 times more likely.&nbsp; Pra?s promising predictive ability may add valuable discharge planning information.</td></tr></table>en_GB
dc.date.available2011-10-26T12:55:48Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T12:55:48Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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