Predictive Modeling May Reduce Hospitalizations

The Visiting Nurse Service of New York has adopted advanced information technology designed to improve patient care. The effort appears to be effective in reducing hospitalizations and re-hospitalizations, according to a paper published in the Journal for Healthcare Quality.

The VNSNY Center for Home Care Policy & Research launched the Outcomes Initiative to support research, evaluation, and informatics services. The system identifies patients at risk for hospitalization, identifies patients eligible for and in need of physical therapy, and assesses the performance of clinical staff and programs.

Together, these and other HIT initiatives have been instrumental in helping VNSNY achieve a 12% decrease in the overall patient rehospitalization rate between 2001 and 2009, according to the authors. They also report a reduction in patient episodes ending in hospitalization, from 37% to 27%, during that period.

Analysis of the VNSNY database revealed several factors that put home-care patients at increased risk of hospitalization: unhealed pressure or stasis ulcers, urinary incontinence, the presence of a catheter, respiratory symptoms, shortness of breath, and congestive heart failure.

A computer model was devised to find the patients and place them in one of seven risk categories, ranging from very low to very high, so that appropriate clinical steps could be taken.

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