{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,7]],"date-time":"2025-11-07T09:45:15Z","timestamp":1762508715839},"reference-count":36,"publisher":"Georg Thieme Verlag KG","issue":"01\/02","funder":[{"name":"German Innovation Funds according to \u00a7 92a (2) Volume V of the Social Insurance Code","award":["01VSF18019"],"award-info":[{"award-number":["01VSF18019"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Methods Inf Med"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:p>\n            Background\u2003Numerous prediction models for readmissions are developed from hospital data whose predictor variables are based on specific data fields that are often not transferable to other settings. In contrast, routine data from statutory health insurances (in Germany) are highly standardized, ubiquitously available, and would thus allow for automatic identification of readmission risks.<\/jats:p><jats:p>\n            Objectives\u2003To develop and internally validate prediction models for readmissions based on potentially inappropriate prescribing (PIP) in six diseases from routine data.<\/jats:p><jats:p>\n            Methods\u2003In a large database of German statutory health insurance claims, we detected disease-specific readmissions after index admissions for acute myocardial infarction (AMI), heart failure (HF), a composite of stroke, transient ischemic attack or atrial fibrillation (S\/AF), chronic obstructive pulmonary disease (COPD), type-2 diabetes mellitus (DM), and osteoporosis (OS). PIP at the index admission was determined by the STOPP\/START criteria (Screening Tool of Older Persons' Prescriptions\/Screening Tool to Alert doctors to the Right Treatment) which were candidate variables in regularized prediction models for specific readmission within 90 days. The risks from disease-specific models were combined (\u201cstacked\u201d) to predict all-cause readmission within 90 days. Validation performance was measured by the c-statistics.<\/jats:p><jats:p>\n            Results\u2003While the prevalence of START criteria was higher than for STOPP criteria, more single STOPP criteria were selected into models for specific readmissions. Performance in validation samples was the highest for DM (c-statistics: 0.68 [95% confidence interval (CI): 0.66\u20130.70]), followed by COPD (c-statistics: 0.65 [95% CI: 0.64\u20130.67]), S\/AF (c-statistics: 0.65 [95% CI: 0.63\u20130.66]), HF (c-statistics: 0.61 [95% CI: 0.60\u20130.62]), AMI (c-statistics: 0.58 [95% CI: 0.56\u20130.60]), and OS (c-statistics: 0.51 [95% CI: 0.47\u20130.56]). Integrating risks from disease-specific models to a combined model for all-cause readmission yielded a c-statistics of 0.63 [95% CI: 0.63\u20130.64].<\/jats:p><jats:p>\n            Conclusion\u2003PIP successfully predicted readmissions for most diseases, opening the possibility for interventions to improve these modifiable risk factors. Machine-learning methods appear promising for future modeling of PIP predictors in complex older patients with many underlying diseases.<\/jats:p>","DOI":"10.1055\/s-0042-1742671","type":"journal-article","created":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T23:58:47Z","timestamp":1644537527000},"page":"055-060","source":"Crossref","is-referenced-by-count":4,"title":["Predicting Hospital Readmissions from Health Insurance Claims Data: A Modeling Study Targeting Potentially Inappropriate Prescribing"],"prefix":"10.1055","volume":"61","author":[{"given":"Alexander","family":"Gerharz","sequence":"first","affiliation":[{"name":"Department of Statistics, Technical University of Dortmund, Dortmund, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Ruff","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucas","family":"Wirbka","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Felicitas","family":"Stoll","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter E.","family":"Haefeli","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas","family":"Groll","sequence":"additional","affiliation":[{"name":"Department of Statistics, Technical University of Dortmund, Dortmund, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas D.","family":"Meid","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology and Pharmacoepidemiology, University of Heidelberg, Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2022,2,10]]},"reference":[{"issue":"05","key":"ref1","doi-asserted-by":"crossref","first-page":"1382","DOI":"10.1111\/bcp.13055","article-title":"Too many, too few, or too unsafe? Impact of inappropriate prescribing on mortality, and hospitalization in a cohort of community-dwelling oldest old","volume":"82","author":"M Wauters","year":"2016","journal-title":"Br J Clin Pharmacol"},{"issue":"12","key":"ref2","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1016\/j.jval.2018.05.007","article-title":"Prediction of drug-related risks using clinical context information in longitudinal claims data","volume":"21","author":"A D Meid","year":"2018","journal-title":"Value Health"},{"issue":"02","key":"ref3","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1056\/NEJMp1212324","article-title":"Post-hospital syndrome\u2013an acquired, transient condition of generalized risk","volume":"368","author":"H M Krumholz","year":"2013","journal-title":"N Engl J Med"},{"issue":"04","key":"ref4","doi-asserted-by":"crossref","first-page":"e0250298","DOI":"10.1371\/journal.pone.0250298","article-title":"Disease-dependent variations in the timing and causes of readmissions in Germany: a claims data analysis for six different conditions","volume":"16","author":"C Ruff","year":"2021","journal-title":"PLoS One"},{"issue":"03","key":"ref5","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1007\/s00228-016-2184-0","article-title":"How can we define and analyse drug exposure more precisely to improve the prediction of hospitalizations in longitudinal (claims) data?","volume":"73","author":"A D Meid","year":"2017","journal-title":"Eur J Clin Pharmacol"},{"issue":"05","key":"ref6","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1111\/jcpt.12059","article-title":"Application of the STOPP\/START criteria: a systematic review of the prevalence of potentially inappropriate prescribing in older adults, and evidence of clinical, humanistic and economic impact","volume":"38","author":"B Hill-Taylor","year":"2013","journal-title":"J Clin Pharm Ther"},{"issue":"12","key":"ref7","doi-asserted-by":"crossref","first-page":"2838","DOI":"10.1111\/bcp.14116","article-title":"Hospitalization as an opportunity to correct errors in anticoagulant treatment in patients with atrial fibrillation","volume":"85","author":"Y Angel","year":"2019","journal-title":"Br J Clin Pharmacol"},{"issue":"03","key":"ref8","doi-asserted-by":"crossref","first-page":"178","DOI":"10.7326\/0003-4819-150-3-200902030-00007","article-title":"A reengineered hospital discharge program to decrease rehospitalization: a randomized trial","volume":"150","author":"B W Jack","year":"2009","journal-title":"Ann Intern Med"},{"issue":"01","key":"ref9","doi-asserted-by":"crossref","first-page":"e0168757","DOI":"10.1371\/journal.pone.0168757","article-title":"Applying the integrated practice unit concept to a modified virtual ward model of care for patients at highest risk of readmission: a randomized controlled trial","volume":"12","author":"L L Low","year":"2017","journal-title":"PLoS One"},{"issue":"08","key":"ref10","doi-asserted-by":"crossref","first-page":"1757","DOI":"10.1111\/bcp.13607","article-title":"Hospital readmissions, mortality and potentially inappropriate prescribing: a retrospective study of older adults discharged from hospital","volume":"84","author":"D Counter","year":"2018","journal-title":"Br J Clin Pharmacol"},{"issue":"11","key":"ref11","doi-asserted-by":"crossref","first-page":"2572","DOI":"10.1111\/bcp.13365","article-title":"Hospitalization rates during potentially inappropriate medication use in a large population-based cohort of older adults","volume":"83","author":"S Varga","year":"2017","journal-title":"Br J Clin Pharmacol"},{"issue":"11","key":"ref12","doi-asserted-by":"crossref","first-page":"1476.e1","DOI":"10.1016\/j.jamda.2019.03.023","article-title":"Clinical implications of potentially inappropriate prescribing according to STOPP\/START version 2 criteria in older polymorbid patients 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polypharmacy: the SENATOR* randomized controlled clinical trial","volume":"49","author":"D O'Mahony","year":"2020","journal-title":"Age Ageing"},{"issue":"01","key":"ref18","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1097\/00005650-199801000-00004","article-title":"Comorbidity measures for use with administrative data","volume":"36","author":"A Elixhauser","year":"1998","journal-title":"Med Care"},{"issue":"05","key":"ref19","doi-asserted-by":"crossref","first-page":"1","DOI":"10.18637\/jss.v039.i05","article-title":"Regularization paths for Cox's proportional hazards model via coordinate descent","volume":"39","author":"N Simon","year":"2011","journal-title":"J Stat Softw"},{"issue":"01","key":"ref20","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1002\/1097-0142(1950)3:1<32::AID-CNCR2820030106>3.0.CO;2-3","article-title":"Index for rating diagnostic tests","volume":"3","author":"W J Youden","year":"1950","journal-title":"Cancer"},{"issue":"02","key":"ref21","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1002\/sim.2929","article-title":"Evaluating the added predictive ability of a new marker: from area under the ROC curve to reclassification and beyond","volume":"27","author":"M J Pencina","year":"2008","journal-title":"Stat Med"},{"issue":"17","key":"ref22","doi-asserted-by":"crossref","first-page":"1822","DOI":"10.1001\/archinte.166.17.1822","article-title":"The care transitions intervention: results of a randomized controlled trial","volume":"166","author":"E A Coleman","year":"2006","journal-title":"Arch Intern Med"},{"issue":"14","key":"ref23","doi-asserted-by":"crossref","first-page":"1238","DOI":"10.1001\/archinternmed.2011.274","article-title":"Effectiveness and cost of a transitional care program for heart failure: a prospective study with concurrent controls","volume":"171","author":"B D Stauffer","year":"2011","journal-title":"Arch Intern Med"},{"issue":"08","key":"ref24","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1002\/jhm.2054","article-title":"Project BOOST: effectiveness of a multihospital effort to reduce rehospitalization","volume":"8","author":"L O Hansen","year":"2013","journal-title":"J Hosp Med"},{"issue":"10","key":"ref25","doi-asserted-by":"crossref","first-page":"950","DOI":"10.1097\/MLR.0000000000000587","article-title":"A systematic review of the impact of potentially inappropriate medication on health care utilization and costs among older adults","volume":"54","author":"V Hyttinen","year":"2016","journal-title":"Med Care"},{"issue":"08","key":"ref26","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1007\/s40266-020-00767-w","article-title":"Potentially inappropriate medications, drug-drug interactions, and anticholinergic burden in elderly hospitalized patients: does an association exist with post-discharge health outcomes?","volume":"37","author":"A De Vincentis","year":"2020","journal-title":"Drugs Aging"},{"issue":"05","key":"ref27","doi-asserted-by":"crossref","first-page":"e62401","DOI":"10.1371\/journal.pone.0062401","article-title":"Effects of pharmacists' interventions on appropriateness of prescribing and evaluation of the instruments' (MAI, STOPP and STARTs') ability to predict hospitalization\u2013analyses from a randomized controlled trial","volume":"8","author":"U Gillespie","year":"2013","journal-title":"PLoS One"},{"issue":"06","key":"ref28","first-page":"271","article-title":"Derivation and validation of a predictive model for the readmission of patients with diabetes mellitus treated in internal medicine departments [in Spanish]","volume":"218","author":"J Ena","year":"2018","journal-title":"Rev Clin Esp (Barc)"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1016\/j.ijcard.2017.02.024","article-title":"Applicability of the heart failure readmission risk score: a first European 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Sci"},{"issue":"01","key":"ref33","doi-asserted-by":"crossref","first-page":"467","DOI":"10.1186\/s12877-020-01867-3","article-title":"Risk factors for hospital readmission in older adults within 30\u2009days of discharge - a comparative retrospective study","volume":"20","author":"M Glans","year":"2020","journal-title":"BMC Geriatr"},{"issue":"06","key":"ref34","doi-asserted-by":"crossref","first-page":"e0253024","DOI":"10.1371\/journal.pone.0253024","article-title":"Medication-related hospital readmissions within 30 days of discharge-A retrospective study of risk factors in older adults","volume":"16","author":"M Glans","year":"2021","journal-title":"PLoS One"},{"issue":"05","key":"ref35","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1007\/s11096-020-01040-1","article-title":"Medication-related hospital admissions and readmissions in older patients: an overview of literature","volume":"42","author":"A EMJH Linkens","year":"2020","journal-title":"Int J Clin 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