IDEAS home Printed from https://ideas.repec.org/a/plo/pone00/0210714.html
   My bibliography  Save this article

Predictive risk score for unplanned 30-day rehospitalizations in the French universal health care system based on a medico-administrative database

Author

Listed:
  • Vanessa Pauly
  • Hélène Mendizabal
  • Stéphanie Gentile
  • Pascal Auquier
  • Laurent Boyer

Abstract

Background: Reducing unplanned rehospitalizations is one of the priorities of health care policies in France and other Western countries. An easy-to-use algorithm for identifying patients at higher risk of rehospitalizations would help clinicians prioritize actions and care concerning discharge transitions. Our objective was to develop a predictive unplanned 30-day all-cause rehospitalization risk score based on the French hospital medico-administrative database. Methods: This was a retrospective cohort study of all 2015 discharges from acute-care inpatient hospitalizations in a tertiary-care university center comprising four hospitals. The study endpoint was unplanned 30-day all-cause rehospitalization via emergency departments, and we collected sociodemographic, clinical, and hospital characteristics based on hospitalization database computed for reimbursement of fees. We derived a predictive rehospitalization risk score using a split-sample design and multivariate logistic regression, and we compared the discriminative properties with the LACE index risk-score. Result: Our analysis included 118,650 hospitalizations, of which 4,127 (3.5%) led to rehospitalizations via emergency departments. Variables independently associated with rehospitalization were age, gender, state-funded medical assistance, as well as disease category and severity, Charlson comorbidity index, hospitalization via emergency departments, length of stay (LOS), and previous hospitalizations 6 months before. The predictive rehospitalization risk score yielded satisfactory discriminant properties (C statistic: 0.74) exceeding the LACE index (0.66). Conclusion: Our findings indicate that the possibility of unplanned rehospitalization remains high for some patient characteristics, indicating that targeted interventions could be beneficial for patients at the greatest risk. We developed an easy-to-use predictive rehospitalization risk-score of unplanned 30-day all-cause rehospitalizations with satisfactory discriminant properties. Future works should, however, explore if other data from electronic medical records and other databases could improve the accuracy of our predictive rehospitalization risk score based on medico-administrative data.

Suggested Citation

  • Vanessa Pauly & Hélène Mendizabal & Stéphanie Gentile & Pascal Auquier & Laurent Boyer, 2019. "Predictive risk score for unplanned 30-day rehospitalizations in the French universal health care system based on a medico-administrative database," PLOS ONE, Public Library of Science, vol. 14(3), pages 1-17, March.
  • Handle: RePEc:plo:pone00:0210714
    DOI: 10.1371/journal.pone.0210714
    as

    Download full text from publisher

    File URL: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0210714
    Download Restriction: no

    File URL: https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0210714&type=printable
    Download Restriction: no

    File URL: https://libkey.io/10.1371/journal.pone.0210714?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Jordan B Strom & Daniel B Kramer & Yun Wang & Changyu Shen & Jason H Wasfy & Bruce E Landon & Elissa H Wilker & Robert W Yeh, 2017. "Short-term rehospitalization across the spectrum of age and insurance types in the United States," PLOS ONE, Public Library of Science, vol. 12(7), pages 1-12, July.
    2. Rodwin, V.G., 2003. "The health care system under French national health insurance: Lessons for health reform in the United States," American Journal of Public Health, American Public Health Association, vol. 93(1), pages 31-37.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Alex R. Horenstein & Manuel S. Santos, 2012. "A Cross-Country Analysis of Health Care Expenditures," Working Papers 2013-05, University of Miami, Department of Economics.
    2. Anne-Laure Feral-Pierssens & Claire Rives-Lange & Joane Matta & Victor G. Rodwin & Marcel Goldberg & Philippe Juvin & Marie Zins & Claire Carette & Sebastien Czernichow, 2020. "Forgoing health care under universal health insurance: the case of France," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 65(5), pages 617-625, June.
    3. Anne-Laure Feral-Pierssens & Claire Rives-Lange & Joane Matta & Victor G. Rodwin & Marcel Goldberg & Philippe Juvin & Marie Zins & Claire Carette & Sebastien Czernichow, 0. "Forgoing health care under universal health insurance: the case of France," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 0, pages 1-9.
    4. Beaussier, Anne-Laure & Demeritt, David & Griffiths, Alex & Rothstein, Henry, 2020. "Steering by their own lights: Why regulators across Europe use different indicators to measure healthcare quality," Health Policy, Elsevier, vol. 124(5), pages 501-510.
    5. Huguet, Marius, 2020. "Centralization of care in high volume hospitals and inequalities in access to care," Social Science & Medicine, Elsevier, vol. 260(C).
    6. Dubois, Pierre & Tunçel, Tuba, 2021. "Identifying the effects of scientific information and recommendations on physicians’ prescribing behavior," Journal of Health Economics, Elsevier, vol. 78(C).
    7. Benjamin Caumeil & Nicolas Bazine & Axel Maugendre & Sarah Calvin, 2024. "Ecosystem Barriers and Facilitators Linked to the Fear of Cancer Recurrence: An Umbrella Review," IJERPH, MDPI, vol. 21(8), pages 1-19, August.
    8. Lemoine, Coralie & Loubière, Sandrine & Boucekine, Mohamed & Girard, Vincent & Tinland, Aurélie & Auquier, Pascal, 2021. "Cost-effectiveness analysis of housing first intervention with an independent housing and team support for homeless people with severe mental illness: A Markov model informed by a randomized controlle," Social Science & Medicine, Elsevier, vol. 272(C).
    9. Marie-Christine Rousseau & Karine Baumstarck & Sherezad Khaldi-Cherif & Catherine Brisse & Agnès Felce & Benjamin Moheng & Anderson Loundou & Thierry Billette de Villemeur & Pascal Auquier & the Frenc, 2019. "Impact of severe polyhandicap on parents’ quality of life: A large French cross-sectional study," PLOS ONE, Public Library of Science, vol. 14(2), pages 1-14, February.
    10. Rosalind Bell-Aldeghi & Nicolas Sirven & Morgane Guern & Christine Sevilla-Dedieu, 2022. "One last effort. Are high out-of-pocket payments at the end of life a fatality?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(5), pages 879-891, July.
    11. Tuncel, Tuba, 2022. "Should We Prevent Off-Label Drug Prescriptions? Empirical Evidence from France," TSE Working Papers 22-1383, Toulouse School of Economics (TSE).
    12. L. F. Andrade & T. Rapp & C. Sevilla-Dedieu, 2018. "Quality of diabetes follow-up care and hospital admissions," International Journal of Health Economics and Management, Springer, vol. 18(2), pages 153-167, June.
    13. Jacek Kryś & Błażej Łyszczarz & Zofia Wyszkowska & Kornelia Kędziora-Kornatowska, 2019. "Prevalence, Reasons, and Predisposing Factors Associated with 30-day Hospital Readmissions in Poland," IJERPH, MDPI, vol. 16(13), pages 1-14, July.
    14. Field, Robert I. & Keller, Catherine & Louazel, Michel, 2020. "Can governments push providers to collaborate? A comparison of hospital network reforms in France and the United States," Health Policy, Elsevier, vol. 124(10), pages 1100-1107.
    15. Tuba Tunçel, 2024. "Should We Prevent Off-Label Drug Prescriptions? Empirical Evidence from France," Post-Print hal-04758877, HAL.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:plo:pone00:0210714. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: plosone (email available below). General contact details of provider: https://journals.plos.org/plosone/ .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.