Background: Untimely social interventions prolong hospitalizations, suggesting discharge planning should begin early. This study aimed to create a tool to identify, already in Emergency department, patients at risk of complex discharge for social reasons. Methods: We developed the Risk Assessment of Complex Discharge Index (RACDI). In Emergency department, we administered RACDI to patients destined to hospitalization. We calculated sensitivity and specificity of RACDI in identifying patients who need a social intervention. RACDI was compared with simplified BRASS. A multivariable logistic regression explored social intervention predictors (P-value < 0.05). Results: RACDI was administered to 296 patients. There were significant associations between classes of risk defined by RACDI or by simplified BRASS and social intervention. The sensitivity of RACDI and simplified BRASS was, respectively, 0.59 and 0.43; the specificity 0.81 and 0.83. Chances of social intervention were higher for patients at high risk with RACDI (adjOR:3.13, 95% CI: 1.23-8.00, P = 0.017). Conclusions: The reduced items and mostly dichotomous answers made RACDI a tool easy to be used in daily practice. RACDI helps in classifying patients needing discharge planning for social care and is a starting point to standardize the evaluation of social context early in hospitalization. Further work is needed to overcome limitations and assess additional outcomes.
Facilitating discharge planning: the Risk Assessment of Complex Discharge Index
Bert, FabrizioFirst
;Cugudda, Eleonora;Lo Moro, Giuseppina
;Devardo, Carolina;Faenzi, Cristina;Siliquini, RobertaLast
2023-01-01
Abstract
Background: Untimely social interventions prolong hospitalizations, suggesting discharge planning should begin early. This study aimed to create a tool to identify, already in Emergency department, patients at risk of complex discharge for social reasons. Methods: We developed the Risk Assessment of Complex Discharge Index (RACDI). In Emergency department, we administered RACDI to patients destined to hospitalization. We calculated sensitivity and specificity of RACDI in identifying patients who need a social intervention. RACDI was compared with simplified BRASS. A multivariable logistic regression explored social intervention predictors (P-value < 0.05). Results: RACDI was administered to 296 patients. There were significant associations between classes of risk defined by RACDI or by simplified BRASS and social intervention. The sensitivity of RACDI and simplified BRASS was, respectively, 0.59 and 0.43; the specificity 0.81 and 0.83. Chances of social intervention were higher for patients at high risk with RACDI (adjOR:3.13, 95% CI: 1.23-8.00, P = 0.017). Conclusions: The reduced items and mostly dichotomous answers made RACDI a tool easy to be used in daily practice. RACDI helps in classifying patients needing discharge planning for social care and is a starting point to standardize the evaluation of social context early in hospitalization. Further work is needed to overcome limitations and assess additional outcomes.File | Dimensione | Formato | |
---|---|---|---|
Accepted version.docx
Accesso riservato
Descrizione: Versione accettata del paper
Tipo di file:
POSTPRINT (VERSIONE FINALE DELL’AUTORE)
Dimensione
74.94 kB
Formato
Microsoft Word XML
|
74.94 kB | Microsoft Word XML | Visualizza/Apri Richiedi una copia |
Accepted+version.pdf
Accesso aperto
Descrizione: Versione accettata del paper
Tipo di file:
POSTPRINT (VERSIONE FINALE DELL’AUTORE)
Dimensione
359.9 kB
Formato
Adobe PDF
|
359.9 kB | Adobe PDF | Visualizza/Apri |
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.