Rates of 30-day readmissions, which are both common and difficult to predict, are of major concern to hospitalists.
“Unfortunately, interventions developed to date have not been universally successful in preventing hospital readmissions for various medical conditions and patient types,” according to a recent article in the Journal of Hospital Medicine. “One potential explanation for this is the inability to reliably predict which patients are at risk for readmission to better target preventative interventions.”
This fact led the authors to perform a study to determine whether the occurrence of automated clinical deterioration alerts (CDAs) could predict 30-day hospital readmission. The 36 variables in the CDA algorithm included age, radiologic agents, and temperature. The retrospective study assessed 3,015 patients admitted to eight general medicine units for all-cause 30-day readmission. Of these, 1,141 patients triggered a CDA, and they were significantly more likely to have a 30-day readmission compared to those who did not trigger a CDA (23.6% versus 15.9%).
The researchers concluded that readily identifiable clinical variables can be identified that predict 30-day readmission.
“It may be important to include these variables in existing prediction tools if pay for performance and across-institution comparisons are to be ‘fair’ to institutions that care for more seriously ill patients,” they write. “The development of an accurate real-time early warning system has the potential to identify patients at risk for various adverse outcomes including clinical deterioration, hospital death and post-discharge readmission. By identifying patients at greatest risk for readmission, valuable healthcare resources can be better targeted to such populations.”
- Micek ST, Samant M, Bailey T, et al. Real-time automated clinical deterioration alerts predict thirty-day hospital readmission [published online ahead of print June 3, 2016]. J Hosp Med. doi:10.1002/jhm.2617.
The Cost of Vaccine Avoidance
Many Americans avoid their recommended vaccines: For example, the Centers for Disease Control and Prevention (CDC) reports that only 42% of U.S. adults age 18 or older received the flu vaccine during the 2015–2016 flu season. A study recently released online by Health Affairs calculated the annual cost of the diseases associated with 10 vaccines the CDC recommends for adults. In 2015, that economic burden was $8.95 billion. A full 80% of that—$7.1 billion—was attributed to unvaccinated people.
- The cost of US adult vaccine avoidance: $8.95 billion in 2015. Health Affairs website. Accessed October 17, 2016