ArticleInternational journal of environmental research and public health2021
LACE Score-Based Risk Management Tool for Long-Term Home Care Patients: A Proof-of-Concept Study in Taiwan.
Article in International journal of environmental research and public health, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Adaptation of the Taiwan Version of the Supportive and Palliative Care Indicators Tool (SPICT-TW) and Its Association with Six-Month Mortality: A Multi-Center Validation Study in Older People.Healthcare (Basel, Switzerland) · 2024Article
- Interventional analytics in skilled nursing facilities associated with reduced readmissions.The American journal of managed care · 2024Article
- Advances in Population-Based Healthcare Research: From Measures to Evidence.International journal of environmental research and public health · 2022Article
- A novel interpretable machine learning system to generate clinical risk scores: An application for predicting early mortality or unplanned readmission in a retrospective cohort study.PLOS digital health · 2022Article
- Development and validation of an interpretable machine learning scoring tool for estimating time to emergency readmissions.EClinicalMedicine · 2022Article
- Analysis of Older Adults under Home Care in Taiwan's Ageing Society.Computational intelligence and neuroscience · 2022Article
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Authors and funding
7 authors.
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Abstract
backgroundEffectively predicting and reducing readmission in long-term home care (LTHC) is challenging. We proposed, validated, and evaluated a risk management tool that stratifies LTHC patients by LACE predictive score for readmission risk, which can further help home care providers intervene with individualized preventive plans.
methodA before-and-after study was conducted by a LTHC unit in Taiwan. Patients with acute hospitalization within 30 days after discharge in the unit were enrolled as two cohorts (Pre-Implement cohort in 2017 and Post-Implement cohort in 2019). LACE score performance was evaluated by calibration and discrimination (AUC, area under receiver operator characteristic (ROC) curve). The clinical utility was evaluated by negative predictive value (NPV).
resultsThere were 48 patients with 87 acute hospitalizations in Pre-Implement cohort, and 132 patients with 179 hospitalizations in Post-Implement cohort. These LTHC patients were of older age, mostly intubated, and had more comorbidities. There was a significant reduction in readmission rate by 44.7% (readmission rate 25.3% vs. 14.0% in both cohorts). Although LACE score predictive model still has room for improvement (AUC = 0.598), it showed the potential as a useful screening tool (NPV, 87.9%; 95% C.I., 74.2-94.8). The reduction effect is more pronounced in infection-related readmission.
conclusionAs real-world evidence, LACE score-based risk management tool significantly reduced readmission by 44.7% in this LTHC unit. Larger scale studies involving multiple homecare units are needed to assess the generalizability of this study.
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