Retrospective cohort.
Cleveland Clinic Main Campus.
Cleveland Clinic Main Campus medicine services patients who were admitted between January 1, 2011, and December 31, 2012, and subsequently discharged to 110 SNFs within a 25-mile radius of the hospital.
Thirty-day all-cause readmissions to any hospital in the Cleveland Clinic Health System and the HOSPITAL score.
During the study period, 4208 medical patients were discharged to 110 SNFs; 30-day all-cause readmission rates were 40.9% for high-risk patients, 28.1% for intermediate-risk patients, and 15.4% for low-risk patients. Compared to intermediate- and low-risk patients, high-risk patients had more hospitalizations in the past year (3.6 vs 1.1 vs 0.8;
Among patients discharged to an SNF, the HOSPITAL score may be used to identify those at highest risk of readmission within 30 days.