Abstract
OBJECTIVES: To test the predictive ability of the Probability of Repeated Admission (PRA) screen for nonroutine discharge planning (requiring new referrals for formal services). DESIGN: Prospective cohort. SETTING: Two hospitals within a large Midwestern, tertiary care, referral-based system. PARTICIPANTS: Nine hundred ninety-one hospitalized adults identified using a systematic sampling strategy. MEASUREMENTS: The PRA screen was administered, and use of nonroutine discharge planning resources and nonroutine discharge disposition were determined using observation and open record review. Prolonged length of stay was determined by comparing the actual length of stay with the combined average length of stay for diagnosis-related groupings. RESULTS: Significant differences in PRA scores existed in two of three endpoints, but the differences were small, and the ranges of scores overlapped almost completely. Using, logistic regression, items predicting use of nonroutine discharge-planning resources were self-rated health, caregiver availability, age, and sex (chi-square (χ2) = 105.7, df = 9, P < .001), accounting for 17.9% of the variability and area under receiver operating characteristic curve (AUC) of 0.74. Self-rated health and sex predicted prolonged length of stay (χ2 = 15.3, df = 5, P = .009), but only explained 2.2% of the variability, with an AUC of 0.58. The predictors of nonroutine discharge disposition were selfrated health, caregiver availability, age, sex, and diabetes mellitus (χ2 = 125.8, df = 11, P < .00l), accounting for 23.0% of the variability, with an AUC of 0.79. CONCLUSION: The clinical utility of using the PRA as a screen for early identification of persons who use nonroutine discharge planning is limited, although certain individual items may be useful.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 678-682 |
| Number of pages | 5 |
| Journal | Journal of the American Geriatrics Society |
| Volume | 51 |
| Issue number | 5 |
| DOIs | |
| State | Published - May 1 2003 |
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Keywords
- Discharge planning
- Elderly
- Hospital discharge
- Screening
ASJC Scopus subject areas
- Geriatrics and Gerontology
Cite this
Prospective evaluation of a screen for complex discharge planning in hospitalized adults. / Holland, Diane E.; Harris, Marcelline R.; Pankratz, V. Shane; Closson, Diane C.; Matt-Hensrud, Natasha N.; Severson, Mary A.
In: Journal of the American Geriatrics Society, Vol. 51, No. 5, 01.05.2003, p. 678-682.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Prospective evaluation of a screen for complex discharge planning in hospitalized adults
AU - Holland, Diane E.
AU - Harris, Marcelline R.
AU - Pankratz, V. Shane
AU - Closson, Diane C.
AU - Matt-Hensrud, Natasha N.
AU - Severson, Mary A.
PY - 2003/5/1
Y1 - 2003/5/1
N2 - OBJECTIVES: To test the predictive ability of the Probability of Repeated Admission (PRA) screen for nonroutine discharge planning (requiring new referrals for formal services). DESIGN: Prospective cohort. SETTING: Two hospitals within a large Midwestern, tertiary care, referral-based system. PARTICIPANTS: Nine hundred ninety-one hospitalized adults identified using a systematic sampling strategy. MEASUREMENTS: The PRA screen was administered, and use of nonroutine discharge planning resources and nonroutine discharge disposition were determined using observation and open record review. Prolonged length of stay was determined by comparing the actual length of stay with the combined average length of stay for diagnosis-related groupings. RESULTS: Significant differences in PRA scores existed in two of three endpoints, but the differences were small, and the ranges of scores overlapped almost completely. Using, logistic regression, items predicting use of nonroutine discharge-planning resources were self-rated health, caregiver availability, age, and sex (chi-square (χ2) = 105.7, df = 9, P < .001), accounting for 17.9% of the variability and area under receiver operating characteristic curve (AUC) of 0.74. Self-rated health and sex predicted prolonged length of stay (χ2 = 15.3, df = 5, P = .009), but only explained 2.2% of the variability, with an AUC of 0.58. The predictors of nonroutine discharge disposition were selfrated health, caregiver availability, age, sex, and diabetes mellitus (χ2 = 125.8, df = 11, P < .00l), accounting for 23.0% of the variability, with an AUC of 0.79. CONCLUSION: The clinical utility of using the PRA as a screen for early identification of persons who use nonroutine discharge planning is limited, although certain individual items may be useful.
AB - OBJECTIVES: To test the predictive ability of the Probability of Repeated Admission (PRA) screen for nonroutine discharge planning (requiring new referrals for formal services). DESIGN: Prospective cohort. SETTING: Two hospitals within a large Midwestern, tertiary care, referral-based system. PARTICIPANTS: Nine hundred ninety-one hospitalized adults identified using a systematic sampling strategy. MEASUREMENTS: The PRA screen was administered, and use of nonroutine discharge planning resources and nonroutine discharge disposition were determined using observation and open record review. Prolonged length of stay was determined by comparing the actual length of stay with the combined average length of stay for diagnosis-related groupings. RESULTS: Significant differences in PRA scores existed in two of three endpoints, but the differences were small, and the ranges of scores overlapped almost completely. Using, logistic regression, items predicting use of nonroutine discharge-planning resources were self-rated health, caregiver availability, age, and sex (chi-square (χ2) = 105.7, df = 9, P < .001), accounting for 17.9% of the variability and area under receiver operating characteristic curve (AUC) of 0.74. Self-rated health and sex predicted prolonged length of stay (χ2 = 15.3, df = 5, P = .009), but only explained 2.2% of the variability, with an AUC of 0.58. The predictors of nonroutine discharge disposition were selfrated health, caregiver availability, age, sex, and diabetes mellitus (χ2 = 125.8, df = 11, P < .00l), accounting for 23.0% of the variability, with an AUC of 0.79. CONCLUSION: The clinical utility of using the PRA as a screen for early identification of persons who use nonroutine discharge planning is limited, although certain individual items may be useful.
KW - Discharge planning
KW - Elderly
KW - Hospital discharge
KW - Screening
UR - http://www.scopus.com/inward/record.url?scp=0038746784&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0038746784&partnerID=8YFLogxK
U2 - 10.1034/j.1600-0579.2003.00213.x
DO - 10.1034/j.1600-0579.2003.00213.x
M3 - Article
VL - 51
SP - 678
EP - 682
JO - Journal of the American Geriatrics Society
JF - Journal of the American Geriatrics Society
SN - 0002-8614
IS - 5
ER -