New Web tool to predict risk of early hospital readmission

A file photograph of patients and nurses in a ward at Singapore General Hospital.
A file photograph of patients and nurses in a ward at Singapore General Hospital.ST PHOTO: SEAH KWANG PENG

SINGAPORE - Researchers here have developed an online "calculator" that can help predict the risk of early hospital readmission.

In Singapore, approximately 15 per cent of patients who have been discharged from hospitals here will be readmitted within 30 days. While not all hospital readmissions are predictable, researchers hope that the new tool will be able to reduce preventable readmissions based on risk factors identified in their study.

"Our model helps to identify patients who are at high risk of an early readmission. These patients are most likely to benefit from interventions such as specialised discharge planning, medication counselling, caregiver training or placing patients on a home visit programme," said Mr Sreemanee Raaj Dorajoo, a PhD candidate from the National University of Singapore's (NUS') Department of Pharmacy, who conducted the study.

To develop the tool, researchers looked at the age, medical conditions and discharge information of more than 300 patients aged 21 and above from Khoo Teck Puat Hospital (KTPH) who were readmitted to hospital within 15 days.

They identified risk factors of readmission in these patients and then validated it with data from a separate group of 621 patients from KTPH and Singapore General Hospital between August and September 2015.

It was found that the number of medications prescribed at discharge was significantly associated with readmission risk. For each additional medication prescribed, the risk of a hospital readmission within 15 days increased by about 6 per cent.

Patients who were discharged to nursing homes were also found to have a higher risk of readmission.

Said Associate Professor Alexandre Chan from the Department of Pharmacy at the NUS Faculty of Science, who supervised the project: "Patients discharged to nursing homes typically require a higher degree of post-discharge care. Ensuring that patients enter appropriate care facilities is therefore an important consideration in stemming the cycle of readmissions."

The research team hopes that healthcare providers can use the Web-based calculator to develop intervention programmes for patients who are at a higher risk of readmission. This could include visits or checking up on the patient after he has been discharged from the hospital.

Discussions are underway to integrate the Web-based calculator into the existing electronic medical records system of healthcare providers in Singapore.

"Hospital readmissions place immense strain on the healthcare system. By cutting down the number of preventable readmissions, hospital-related healthcare costs can be significantly reduced," added Prof Chan.