ArticleBMC health services research2021
Social determinants of health and hospital readmissions: can the HOSPITAL risk score be improved by the inclusion of social factors?
Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Rehabilitation and Social Determinants of Health in Critical Illness Recovery Literature: A Systematic Review.Critical care explorations · 2024Pooled it
- Machine learning using PROFUND components for 30-day readmission prediction in multimorbid patients: a prospective multicentre study.Scientific reports · 2026Article
- Postpartum readmission for hypertension: Validating a predictive model with incorporation of neighborhood-level social determinants of health.Pregnancy (Hoboken, N.J.) · 2026Article
- Leveraging a machine learning model to predict hospital readmission risk: integrating clinical and social determinants of health data.Frontiers in public health · 2026Article
- Heart Failure Readmission Prevention Strategies-A Comparative Review of Medications, Devices, and Other Interventions.Journal of clinical medicine · 2025Review
- Using social risks to predict unplanned hospital readmission and emergency care among hospitalized Veterans.Health services research · 2025Article
- Inpatient screening for social determinants of health: A quality improvement initiative.Journal of clinical and translational science · 2024Article
- Risk factors for medication-related short-term readmissions in adults - a scoping review.BMC health services research · 2023Article
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe HOSPITAL Risk Score (HRS) predicts 30-day hospital readmissions and is internationally validated. Social determinants of health (SDOH) such as low socioeconomic status (SES) affect health outcomes and have been postulated to affect readmission rates. We hypothesized that adding SDOH to the HRS could improve its predictive accuracy.
methodsRecords of 37,105 inpatient admissions at the University of Chicago Medical Center were reviewed. HRS was calculated for each patient. Census tract-level SDOH then were combined with the HRS and the performance of the resultant "Social HRS" was compared against the HRS. Patients then were assigned to 1 of 7 typologies defined by their SDOH and a balanced dataset of 14,235 admissions was sampled from the larger dataset to avoid over-representation by any 1 sociodemographic group. Principal component analysis and multivariable linear regression then were performed to determine the effect of SDOH on the HRS.
resultsThe c-statistic for the HRS predicting 30-day readmission was 0.74, consistent with published values. However, the addition of SDOH to the HRS did not improve the c-statistic (0.71). Patients with unfavorable SDOH (no high-school, limited English, crowded housing, disabilities, and age > 65 yrs) had significantly higher HRS (p < 0.05 for all). Overall, SDOH explained 0.2% of the HRS.
conclusionAt an urban tertiary care center, the addition of census tract-level SDOH to the HRS did not improve its predictive power. Rather, the effects of SDOH are already reflected in the HRS.
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