PMID- 30462246
OWN - NLM
STAT- MEDLINE
DCOM- 20200601
LR  - 20200601
IS  - 1464-3677 (Electronic)
IS  - 1353-4505 (Linking)
VI  - 31
IP  - 8
DP  - 2019 Oct 31
TI  - Prospectively identifying older adults at risk for potentially avoidable 
      hospitalizations in Korea using population-based data.
PG  - 620-626
LID - 10.1093/intqhc/mzy225 [doi]
AB  - OBJECTIVE: The purpose of this study is to develop and validate a prediction 
      model to identify older adults at risk for potentially avoidable hospitalizations 
      (PAHs) using variables readily available in routinely collected health 
      administrative data. DESIGN: Population-based, retrospective observational study 
      using National Health Insurance Service-National Sample Cohort (NHIS-NSC) data. 
      SETTING: Primary care settings in South Korea. PARTICIPANTS: The sample includes 
      113 612 older NHI beneficiaries in the year 2011, among which 2856 had one or 
      more PAHs in 2012. METHODS: We examined multi-dimensional risk factors of PAHs in 
      the base year and developed and validated prediction models of hospitalization 
      risk using the following year. The predictive power of the developed models was 
      examined with samples generated by the bootstrap method. The performance of the 
      final model was evaluated with further test statistics at different risk 
      thresholds. MAIN OUTCOME MEASURE: Predicting PAHs. RESULTS: The c-statistic of 
      the final predictive model was 0.784 (CI: 0.769-0.799). The final model including 
      all selected predictors showed the greatest marginal improvement (integrated 
      discrimination improvement of 365%) compared to the base model. The positive 
      predictive value was good. CONCLUSIONS: Our prediction model based on health 
      administrative data can assist the insurer and practitioners to proactively 
      identify and intervene with older adults at risk for a PAH.
CI  - (c) The Author(s) 2019. Published by Oxford University Press in association with 
      the International Society for Quality in Health Care. All rights reserved. For 
      permissions, please e-mail: journals.permissions@oup.com.
FAU - Kim, Hongsoo
AU  - Kim H
AD  - Graduate School of Public Health, Department of Public Health Science, Institute 
      of Health and Environment, & Institute of Aging, Seoul National University, 
      Seoul, South Korea.
FAU - Jung, Young-Il
AU  - Jung YI
AD  - Department of Environmental Health, College of Natural Science, Korea National 
      Open University, Seoul, South Korea.
FAU - Kim, Kyoung Hoon
AU  - Kim KH
AD  - Review and Assessment Research Team, Health Insurance Review and Assessment 
      Service, Wonju, South Korea.
FAU - Park, Jung Min
AU  - Park JM
AD  - Department of Social Welfare, College of Social Sciences, Seoul National 
      University, Seoul, South Korea.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - England
TA  - Int J Qual Health Care
JT  - International journal for quality in health care : journal of the International 
      Society for Quality in Health Care
JID - 9434628
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Female
MH  - Hospitalization/*statistics & numerical data
MH  - Humans
MH  - Male
MH  - Medical Overuse/statistics & numerical data
MH  - *Models, Statistical
MH  - Republic of Korea
MH  - Retrospective Studies
MH  - Risk Factors
OTO - NOTNLM
OT  - appropriate healthcare utilization
OT  - elderly
OT  - health administrative data
OT  - hospitalization
OT  - risk assessment
OT  - statistical methods
EDAT- 2018/11/22 06:00
MHDA- 2020/06/02 06:00
CRDT- 2018/11/22 06:00
PHST- 2018/03/20 00:00 [received]
PHST- 2018/09/11 00:00 [revised]
PHST- 2018/11/08 00:00 [accepted]
PHST- 2018/11/22 06:00 [pubmed]
PHST- 2020/06/02 06:00 [medline]
PHST- 2018/11/22 06:00 [entrez]
AID - 5193420 [pii]
AID - 10.1093/intqhc/mzy225 [doi]
PST - ppublish
SO  - Int J Qual Health Care. 2019 Oct 31;31(8):620-626. doi: 10.1093/intqhc/mzy225.