Please use this identifier to cite or link to this item: http://hdl.handle.net/2445/172729
Title: Health outcomes from home hospitalization: multisource predictive modeling
Author: Calvo, Mireia
González, Ruben
Seijas, Nuria
Vela, Emili
Hernández, Carme
Batiste, Guillem
Miralles Barrachina, Felip
Roca Torrent, Josep
Cano Franco, Isaac
Jané, Raimon
Keywords: Atenció domiciliària
Salut pública
Home care services
Public health
Issue Date: 7-Oct-2020
Publisher: JMIR Publications
Abstract: Background: Home hospitalization is widely accepted as a cost-effective alternative to conventional hospitalization for selected patients. A recent analysis of the home hospitalization and early discharge (HH/ED) program at Hospital Clínic de Barcelona over a 10-year period demonstrated high levels of acceptance by patients and professionals, as well as health value-based generation at the provider and health-system levels. However, health risk assessment was identified as an unmet need with the potential to enhance clinical decision making. Objective: The objective of this study is to generate and assess predictive models of mortality and in-hospital admission at entry and at HH/ED discharge. Methods: Predictive modeling of mortality and in-hospital admission was done in 2 different scenarios: at entry into the HH/ED program and at discharge, from January 2009 to December 2015. Multisource predictive variables, including standard clinical data, patients' functional features, and population health risk assessment, were considered. Results: We studied 1925 HH/ED patients by applying a random forest classifier, as it showed the best performance. Average results of the area under the receiver operating characteristic curve (AUROC; sensitivity/specificity) for the prediction of mortality were 0.88 (0.81/0.76) and 0.89 (0.81/0.81) at entry and at home hospitalization discharge, respectively; the AUROC (sensitivity/specificity) values for in-hospital admission were 0.71 (0.67/0.64) and 0.70 (0.71/0.61) at entry and at home hospitalization discharge, respectively. Conclusions: The results showed potential for feeding clinical decision support systems aimed at supporting health professionals for inclusion of candidates into the HH/ED program, and have the capacity to guide transitions toward community-based care at HH discharge.
Note: Reproducció del document publicat a: https://doi.org/10.2196/21367
It is part of: Journal of Medical Internet Research, 2020, vol. 22, num. 10, p. e21367
URI: http://hdl.handle.net/2445/172729
Related resource: https://doi.org/10.2196/21367
ISSN: 1438-8871
Appears in Collections:Articles publicats en revistes (Medicina)
Articles publicats en revistes (IDIBAPS: Institut d'investigacions Biomèdiques August Pi i Sunyer)

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