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Predicting unplanned hospital visits in older home care recipients : a cross-country external validation study

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dc.contributor.author Klunder, Jet H.
dc.contributor.author Bordonis, Veronique
dc.contributor.author Heymans, Martijn W.
dc.contributor.author van der Roest, Henriëtte G.
dc.contributor.author Declercq, Anja
dc.contributor.author Smit, Jan H.
dc.contributor.author Garms-Homolova, Vjenka
dc.contributor.author Jónsson, Pálmi V.
dc.contributor.author Finne-Soveri, Harriet
dc.contributor.author Onder, Graziano
dc.contributor.author Joling, Karlijn J.
dc.contributor.author Maarsingh, Otto R.
dc.contributor.author van Hout, Hein P.J.
dc.date.accessioned 2022-03-29T01:02:42Z
dc.date.available 2022-03-29T01:02:42Z
dc.date.issued 2021-10-14
dc.identifier.citation Klunder , J H , Bordonis , V , Heymans , M W , van der Roest , H G , Declercq , A , Smit , J H , Garms-Homolova , V , Jónsson , P V , Finne-Soveri , H , Onder , G , Joling , K J , Maarsingh , O R & van Hout , H P J 2021 , ' Predicting unplanned hospital visits in older home care recipients : a cross-country external validation study ' , BMC Geriatrics , vol. 21 , no. 1 , 551 , pp. 551 . https://doi.org/10.1186/s12877-021-02521-2
dc.identifier.issn 1471-2318
dc.identifier.other PURE: 41921062
dc.identifier.other PURE UUID: 35194efe-a899-4179-b485-1bc52afbf778
dc.identifier.other Scopus: 85117304309
dc.identifier.other WOSLite: 000707345800004
dc.identifier.uri https://hdl.handle.net/20.500.11815/2988
dc.description Funding Information: The IBenC project was a Collaborative Research Project funded by the European Union in the Programme: FP7-HEALTH-2012-INNOVATION-1 under grant agreement no. 305912. The funding had no role in study design, data collection, analysis, and interpretation, or preparation of the manuscript. Funding Information: This research was supported by Stichting Preventie Vroegdiagnostiek en e-Health. The authors thank the home care clients and home care organizations for their involvement in the project. Publisher Copyright: © 2021, The Author(s).
dc.description.abstract Background: Accurate identification of older persons at risk of unplanned hospital visits can facilitate preventive interventions. Several risk scores have been developed to identify older adults at risk of unplanned hospital visits. It is unclear whether risk scores developed in one country, perform as well in another. This study validates seven risk scores to predict unplanned hospital admissions and emergency department (ED) visits in older home care recipients from six countries. Methods: We used the IBenC sample (n = 2446), a cohort of older home care recipients from six countries (Belgium, Finland, Germany, Iceland, Italy and The Netherlands) to validate four specific risk scores (DIVERT, CARS, EARLI and previous acute admissions) and three frailty indicators (CHESS, Fried Frailty Criteria and Frailty Index). Outcome measures were unplanned hospital admissions, ED visits or any unplanned hospital visits after 6 months. Missing data were handled by multiple imputation. Performance was determined by assessing calibration and discrimination (area under receiver operating characteristic curve (AUC)). Results: Risk score performance varied across countries. In Iceland, for any unplanned hospital visits DIVERT and CARS reached a fair predictive value (AUC 0.74 [0.68–0.80] and AUC 0.74 [0.67–0.80]), respectively). In Finland, DIVERT had fair performance predicting ED visits (AUC 0.72 [0.67–0.77]) and any unplanned hospital visits (AUC 0.73 [0.67–0.77]). In other countries, AUCs did not exceed 0.70. Conclusions: Geographical validation of risk scores predicting unplanned hospital visits in home care recipients showed substantial variations of poor to fair performance across countries. Unplanned hospital visits seem considerably dependent on healthcare context. Therefore, risk scores should be validated regionally before applied to practice. Future studies should focus on identification of more discriminative predictors in order to develop more accurate risk scores.
dc.format.extent 551
dc.language.iso en
dc.relation info:eu-repo/grantAgreement/EC/FP7/
dc.relation.ispartofseries BMC Geriatrics; 21(1)
dc.rights info:eu-repo/semantics/openAccess
dc.subject Áhættugreining
dc.subject Bráðadeildir
dc.subject Heimahjúkrun
dc.subject Aldraðir
dc.subject Emergency department visits
dc.subject Geographical validation
dc.subject Home care
dc.subject Risk prediction models
dc.subject Unplanned hospitalizations
dc.subject Emergency Service, Hospital
dc.subject Humans
dc.subject Risk Factors
dc.subject Home Care Services
dc.subject Hospitals
dc.subject Aged, 80 and over
dc.subject Frailty
dc.subject Aged
dc.subject Geriatrics and Gerontology
dc.subject 305912
dc.title Predicting unplanned hospital visits in older home care recipients : a cross-country external validation study
dc.type /dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article
dc.description.version Peer reviewed
dc.identifier.pmid 34649526
dc.identifier.doi https://doi.org/10.1186/s12877-021-02521-2
dc.relation.url http://www.scopus.com/inward/record.url?scp=85117304309&partnerID=8YFLogxK
dc.contributor.department Faculty of Medicine
dc.contributor.department Geriatric and Rehabilitation Services


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