Key result
The 30-day all-cause readmission rate was 21.3%, with the CHAID algorithm identifying a main diagnosis of neoplasm as the most significant risk factor for readmission.
Cohort (n=2,622)
No
The CHAID algorithm effectively identifies readmission risk factors, highlighting neoplasm as the most significant predictor of 30-day readmission in internal medicine patients.
Answers are grounded in this paper and cite their sources.
Neoplasm flags high readmission risk in internal medicine; leaves open whether CHAID improves prospective stratification.
OBJECTIVE: To identify frequency of readmission after discharge from internal-medicine wards, readmission risk factors, and reasons and costs of readmission. DESIGN: Prospective cohort study. SETTING: A tertiary-care hospital in Turkey. PARTICIPANTS: 2622 adult patients discharged from internal-medicine wards of the hospital between 1 February 2015 and 31 January 2016. MAIN OUTCOME MEASURES: Thirty day all-cause readmission rates, reasons and costs of readmission. To identify readmission risk factors Chi-square Automatic Interaction Detector (CHAID) analysis was conducted. RESULTS: The same hospital readmission rate was 17.9%, while the same hospital or different-hospital readmission rate was 21.3%. Receiver operating characteristic (ROC) curve analysis showed that the predictive performance of the CHAID algorithm was high. According to the CHAID algorithm, the most significant readmission risk factor was the main diagnosis of neoplasm at the index admission. In other diagnosis groups, higher Charlson comorbidity score, higher level of education, having a regular physician, and three dimensions of Readiness for Hospital Discharge Scale were significant risk factors for readmission. The most frequent reason for readmission was neoplasm, and the total cost of readmissions was ~$900 000. CONCLUSIONS: The CHAID algorithm for readmissions had a high predictive strength and provided details that aid physicians in decision-making. Measures must be taken from initial diagnosis to post-discharge follow-up, to minimize readmissions, especially in patients with neoplasm.
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Kaya et al. (2018) conducted a cohort in Discharged from internal-medicine wards (n=2,622). CHAID algorithm was evaluated on Thirty day all-cause readmission rates, reasons and costs of readmission. The 30-day all-cause readmission rate was 21.3%, with the CHAID algorithm identifying a main diagnosis of neoplasm as the most significant risk factor for readmission.
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