from the June 27, 2011 issue of  Connect

New study: patients at high risk for hospital readmission need special care

Every year one-fifth of patients are readmitted to the hospital after being discharged. Unplanned hospital readmissions are common and expensive. But the good news is, they are also often preventable. Simply by identifying which patients are at high risk for readmission, health-care professionals can offer improved post-discharge care and help keep patients out of hospital.

That’s what motivated Dr. Andrea Gruneir, scientist, Women’s College Hospital Research Institute, and a team of researchers to conduct a study using the LACE index (a recently published and validated algorithm) to identify patients considered high risk for readmission and examine hospital readmission rates. The study, entitled “Unplanned readmissions after hospital discharge among patients identified as being at high risk for readmission using a validated predictive algorithm,” was recently published in Open Medicine.

The LACE index uses four factors to gauge the risk of death or unplanned readmission within 30 days of hospital discharge:

1. length of stay in days
2. acuity of illness at the time of admission
3. Charlson co-morbidity score (a measure of the number and severity of a person’s chronic condition)
4. number of emergency department visits in the six months leading up to hospitalization

“Having an algorithm that can help determine which patients are high-risk is a critical first step in reducing hospital readmission rates,” explains Dr. Gruneir. “Knowing which patients need extra attention at discharge will help health-care professionals improve the discharge process and plan for specialized care where necessary.”

The study determined that the LACE index is a potentially useful tool to determine which patients are best suited for post-discharge interventions. That way health-care providers can create specialized programs for these patients in order to decrease the rate of unplanned readmissions. In fact, St. Michael’s Hospital is already using the LACE index to determine which patients would benefit most from Women’s College Hospital’s Virtual Ward.

To read the study in full click here.