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Hospital Readmission and Social Risk Factors Identified from Physician Notes.


ABSTRACT:

Objective

To evaluate the prevalence of seven social factors using physician notes as compared to claims and structured electronic health records (EHRs) data and the resulting association with 30-day readmissions.

Study setting

A multihospital academic health system in southeastern Massachusetts.

Study design

An observational study of 49,319 patients with cardiovascular disease admitted from January 1, 2011, to December 31, 2013, using multivariable logistic regression to adjust for patient characteristics.

Data collection/extraction methods

All-payer claims, EHR data, and physician notes extracted from a centralized clinical registry.

Principal findings

All seven social characteristics were identified at the highest rates in physician notes. For example, we identified 14,872 patient admissions with poor social support in physician notes, increasing the prevalence from 0.4 percent using ICD-9 codes and structured EHR data to 16.0 percent. Compared to an 18.6 percent baseline readmission rate, risk-adjusted analysis showed higher readmission risk for patients with housing instability (readmission rate 24.5 percent; p < .001), depression (20.6 percent; p < .001), drug abuse (20.2 percent; p = .01), and poor social support (20.0 percent; p = .01).

Conclusions

The seven social risk factors studied are substantially more prevalent than represented in administrative data. Automated methods for analyzing physician notes may enable better identification of patients with social needs.

SUBMITTER: Navathe AS 

PROVIDER: S-EPMC5867172 | biostudies-literature | 2018 Apr

REPOSITORIES: biostudies-literature

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Publications

Hospital Readmission and Social Risk Factors Identified from Physician Notes.

Navathe Amol S AS   Zhong Feiran F   Lei Victor J VJ   Chang Frank Y FY   Sordo Margarita M   Topaz Maxim M   Navathe Shamkant B SB   Rocha Roberto A RA   Zhou Li L  

Health services research 20170313 2


<h4>Objective</h4>To evaluate the prevalence of seven social factors using physician notes as compared to claims and structured electronic health records (EHRs) data and the resulting association with 30-day readmissions.<h4>Study setting</h4>A multihospital academic health system in southeastern Massachusetts.<h4>Study design</h4>An observational study of 49,319 patients with cardiovascular disease admitted from January 1, 2011, to December 31, 2013, using multivariable logistic regression to a  ...[more]

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