Predicting Individual Risk of Emergency Hospital Admissions - A Retrospective Validation Study

Overview

Journal Risk Manag Healthc Policy

Publisher Dove Medical Press

Specialty Public Health

Date 2021 Sep 23

PMID 34552360

Citations 1

Authors

Kirstine Skov Benthien

Rikke Kart Jacobsen

Louise Hjarnaa

Gert Mehl Virenfeldt

Knud Rasmussen

Ulla Toft

Affiliations

Soon will be listed here.

Abstract

Purpose: A high number of hospital admissions may indicate poor general health and less than optimal health care across sectors. To prevent hospital admissions, previous studies have focused on predicting readmissions relating to a defined index admission and specific condition, whereas generic models suited for community-dwelling persons are lacking. The aim of this study was to validate a generic model that predicted risk of emergency hospital admission within the following three months and to investigate regional variation.

Materials And Methods: This study is an observational register-based validation study of a prediction model. The prediction model was based on a population of frail elderly, persons with non-communicable diseases, and persons with three emergency hospital admissions using information about diagnoses and hospital contacts. The prediction model consisted of two stages. In the first stage, covariate associations to admissions are estimated from observed data in one year. In the second stage, admissions are predicted in the coming three months based on observed estimations from the first stage. The validity of the model was calculated by comparing predicted and observed admissions from August 1st to October 31st, 2016.

Results: The study included 112,026 persons. In nationwide data, area under the curve (AUC) was 0.7742 (95% CI 0.7698-0.7786), and the positive predictive value was 52% for the 99th percentile (the top 1%). AUC varied between regions from 0.6914 in Southern Denmark (95% CI 0.6779-0.7049) to 0.8224 (95% CI 0.8064-0.8384) in North Denmark. AUC was higher with nationwide data compared to regional.

Conclusion: The model performed satisfactorily in predicting individual risk of emergency hospital admission.

Citing Articles

Who benefits from self-management support? Results from a randomized controlled trial.

Benthien K, Nielsen C, Rasmussen K, Kidholm K, Gronkjaer M, Toft U Heliyon. 2023; 9(7):e17752.

PMID: 37449182 PMC: 10336573. DOI: 10.1016/j.heliyon.2023.e17752.

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