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'Rothman Index' May Help Lower Repeat Hospitalization Risk

Scores calculated from electronic medical records (August 15)

A health risk score calculated automatically using routine data from hospital electronic medical record (EMR) systems can identify patients at high risk of unplanned hospital readmission, according to a study in the September issue of Medical Care.

The score, called the Rothman Index, may provide a useful tool for lowering the rate of avoidable repeat hospitalizations, the report suggests.

The Rothman Index software uses information from the hospital EMR system to provide a continuously updated score indicating the likelihood of death or readmission within 30 days.

The score is calculated automatically using routine data on each patient's vital signs, routine nursing assessments, skin condition, heart rhythms, and laboratory tests. Lower Rothman Index scores (from a maximum of 100) indicate a higher risk of readmission.

Elizabeth Bradley, PhD, of the Yale School of Public Health, and her colleagues evaluated the ability of the Rothman Index to predict hospital readmission, based on data from more than 2,700 patients hospitalized during 2011. Sixteen percent of the patients had an unplanned readmission within 30 days after hospital discharge.

The Rothman Index was strongly associated with the risk of unplanned readmission. For patients in the highest-risk category — Rothman Index less than 70 — readmission risk was more than 1 in 5. By comparison, for those in the lowest-risk category — Rothman Index 80 or higher — the risk was about 1 in 10.

After adjustment for other factors, patients in the highest versus lowest risk category were more than two and a half times as likely to be readmitted within 30 days of discharge. The Rothman Index predicted readmission across diagnoses and medical specialties.

Implemented into daily care, the Rothman Index could provide “a practical way for clinicians to identify patients who might be at higher risk for unplanned readmission and intervene specifically for these patients to try to avert unplanned readmission,” the authors write.

Source: EurekAlert; August 15, 2013.

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