The Effect of the Use of Frailty Scores and Hospital Score on 30- Day Hospital Readmissions in Geriatric Patients Admitted to the Emergency Department

Abstract

Objective: Assessing the efficiency of healthcare systems is commonly done by analyzing the 30-day readmission rates. However, research on the effectiveness of readmission models, particularly in predicting 30-day unplanned readmissions in the older adult population with frailty, is insufficient.Materials and Methods: This study analyzed 423 older patients who were admitted to the emergency department observation ward and evaluated their frailty scores and HOSPITAL scores. The HOSPITAL score's index admission criteria were modified to suit hospitalization. To assess the overall performance of each prediction model, the scaled Brier score was computed for the HOSPITAL score with and without the frailty scores.Results: The analysis was performed on 320 of the patients, consisting of 188 (58.8%) females and 132 (41.3%) males, with ages ranging from 65 to 99 years, and a mean age of 79.05 years (standard deviation =10.76). The readmission rate was observed to be 43.17%. The models evaluated were (1) hospital only, (2) hospital + clinical frailty score (CFS), and (3) hospital + CFS + PRISMA-7. The scaled Brier scores for all models were computed, and it was found that the score was the same for all models, with a value of 0.02. This value indicates that the overall accuracy of the prediction of 30-day readmission is good.Conclusion: While hospital readmissions can be prevented, relying solely on scoring systems may not be effective. Instead, case-based approaches using patient admissions may provide more meaningful results. Although the HOSPITAL score can predict 30-day readmissions, the frailty test may not to be a predictor.