{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T05:07:56Z","timestamp":1791781676682,"version":"4.3.4"},"reference-count":34,"publisher":"Public Library of Science (PLoS)","issue":"11","license":[{"start":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T00:00:00Z","timestamp":1731456000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100024780","name":"Digital Health Cooperative Research Centre","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100024780","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To identify latent clusters among urological patients by examining hospitalisation rate trajectories and their association with risk factors and outcome quality indicators.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Materials and methods<\/jats:title>\n<jats:p>Victorian Admitted Episodes Dataset, containing information on all hospital admissions in Victoria from 2009 to 2019. The top twenty ICD-10 primary diagnosis codes in urology were used to select patients (n = 98,782) who were included in the study. Latent class trajectory modelling (LCTM) was used to cluster urological patient hospitalisation trajectories. Logistic regression was used to find baseline factors that influence cluster membership, the variables tested included comorbidities, baseline diagnosis codes, and socio-demographic factors. The analysis was further stratified into non-surgical procedures and surgical procedures.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Five clusters of hospitalisation trajectories were identified based on clustering hospitalisation rates over time. Higher hospitalisation clusters were strongly associated with longer length of stay, higher readmission rates and higher complication rates. Higher-risk groups were strongly associated with comorbidities such as renal disease and diabetes. For surgical procedures, urological cancers (kidney, prostate and bladder cancer) and irradiation cystitis were associated with higher-risk groups. For non-surgical procedures, calculus of the bladder, urethral stricture and bladder neck obstruction were associated with higher-risk groups. For patients with two or more admissions, liver cardiovascular disease and being diagnosed with benign prostatic hyperplasia were also associated with higher risk groups.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>A novel statistical approach to cluster hospitalisation trajectories for urological patients was used to explore potential clusters of patient risks and their associations with outcome quality indicators. This study supports the observation that baseline comorbidities and diagnosis can be predictive of higher hospitalisation rates and, therefore, poorer health outcomes. This demonstrates that it is possible to identify patients at risk of developing complications, higher length of stay and readmissions by using baseline comorbidities and diagnosis from administrative data.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0310981","type":"journal-article","created":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T18:31:23Z","timestamp":1731522683000},"page":"e0310981","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Using large administrative data for mining patients\u2019 trajectories for risk stratification: An example from urological diseases"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4304-2783","authenticated-orcid":true,"given":"Harvey Jia Wei","family":"Koh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dragan","family":"Ga\u0161evi\u0107","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Rankin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Frydenberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella","family":"Talic","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2024,11,13]]},"reference":[{"key":"pone.0310981.ref001","article-title":"Audit and feedback: effects on professional practice and healthcare outcomes.","author":"Cochrane Effective Practice and Organisation of Care Group","year":"2012","journal-title":"Cochrane Database Syst Rev."},{"key":"pone.0310981.ref002","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/1471-2377-6-20","article-title":"Duration of hospital participation in a nationwide stroke registry is associated with improved quality of care","volume":"6","author":"NK Hills","year":"2006","journal-title":"BMC Neurol"},{"key":"pone.0310981.ref003","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1001\/jama.290.1.49","article-title":"Use of Continuous Quality Improvement to Increase Use of Process Measures in Patients Undergoing Coronary Artery Bypass Graft Surgery: A Randomized Controlled Trial","volume":"290","author":"TB Jr Ferguson","year":"2003","journal-title":"JAMA"},{"key":"pone.0310981.ref004","doi-asserted-by":"crossref","first-page":"244","DOI":"10.5694\/j.1326-5377.2010.tb03499.x","article-title":"Clinical-quality registries: their role in quality improvement.","volume":"192","author":"JJ McNeil","year":"2010","journal-title":"Med J Aust"},{"key":"pone.0310981.ref005","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1111\/j.1445-5994.2009.02068.x","article-title":"A survey of Australian clinical registries: can quality of care be measured?","volume":"41","author":"SM Evans","year":"2011","journal-title":"Intern Med J"},{"key":"pone.0310981.ref006","volume-title":"Economic evaluation of clinical quality registries: Final report","author":"The Australian Commission on Safety and Quality in Health Care.","year":"2016"},{"key":"pone.0310981.ref007","article-title":"Using practice analytics to understand variation and support re-flective practice: A protocol for a comprehensive digital health re-search program (Preprint).","author":"A Janssen","year":"2021","journal-title":"JMIR Research Protocols"},{"key":"pone.0310981.ref008","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1111\/j.1445-5994.2009.01961.x","article-title":"Measuring the quality of hospital care: an inventory of indicators","volume":"39","author":"B Copnell","year":"2009","journal-title":"Intern Med J"},{"issue":"22","key":"pone.0310981.ref009","first-page":"00288","article-title":"Quality Indicators in the Clinical Specialty of Urology: A Systematic Review.","volume":"S2405-4569","author":"HJW Koh","year":"2022","journal-title":"Eur Urol Focus"},{"key":"pone.0310981.ref010","doi-asserted-by":"crossref","first-page":"2015","DOI":"10.1177\/0962280216673085","article-title":"Group-based multi-trajectory modeling.","volume":"27","author":"DS Nagin","year":"2018","journal-title":"Stat Methods Med Res"},{"key":"pone.0310981.ref011","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1186\/s13011-021-00426-2","article-title":"The influence of multidimensional deprivation on problem drinking developmental trajectory among young adults: a longitudinal study using latent class growth analysis.","volume":"16","author":"SB Lee","year":"2021","journal-title":"Subst Abuse Treat Prev Policy"},{"key":"pone.0310981.ref012","article-title":"Asthma Trajectories in Early Childhood: Identifying Modifiable Factors |","journal-title":"PLOS ONE"},{"key":"pone.0310981.ref013","doi-asserted-by":"crossref","first-page":"e000243","DOI":"10.1136\/bmjdrc-2016-000243","article-title":"High-risk glycated hemoglobin trajectories established by mid-20s: findings from a birth cohort study.","volume":"4","author":"DM Shearer","year":"2016","journal-title":"BMJ Open Diabetes Res Care."},{"key":"pone.0310981.ref014","doi-asserted-by":"crossref","first-page":"1592","DOI":"10.1016\/j.ekir.2021.03.883","article-title":"Hospitalization Trajectories and Risks of ESKD and Death in Individuals With CKD","volume":"6","author":"A Srivastava","year":"2021","journal-title":"Kidney Int Rep"},{"key":"pone.0310981.ref015","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1186\/s40001-022-00754-4","article-title":"Preadmission assessment of extended length of hospital stay with RFECV-ETC and hospital-specific data.","volume":"27","author":"CI Ossai","year":"2022","journal-title":"Eur J Med Res"},{"key":"pone.0310981.ref016","doi-asserted-by":"crossref","first-page":"1130","DOI":"10.1097\/01.mlr.0000182534.19832.83","article-title":"Coding algorithms for defining comorbidities in ICD-9-CM and ICD-10 administrative data.","volume":"43","author":"H Quan","year":"2005","journal-title":"Med Care."},{"key":"pone.0310981.ref017","article-title":"Quality Indicators in Clinical Speciality of Urology: A Systematic Review.","author":"Koh","journal-title":"Rev"},{"key":"pone.0310981.ref018","author":"Australian Commission on Safety and Quality in Health Care","journal-title":"Hospital-Acquired Complications (HACs) List."},{"key":"pone.0310981.ref019","doi-asserted-by":"crossref","first-page":"e020683","DOI":"10.1136\/bmjopen-2017-020683","article-title":"Framework to construct and interpret latent class trajectory modelling","volume":"8","author":"H Lennon","year":"2018","journal-title":"BMJ Open"},{"key":"pone.0310981.ref020","volume-title":"Clustering of longitudinal data: A tutorial on a variety of approaches","author":"ND Teuling","year":"2021"},{"key":"pone.0310981.ref021","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.1002\/cpt.865","article-title":"Group\u2010Based Trajectory Models: Assessing Adherence to Antihypertensive Medication in Older Adults in a Community Pharmacy Setting","volume":"103","author":"P Dillon","year":"2018","journal-title":"Clin Pharmacol Ther"},{"key":"pone.0310981.ref022","unstructured":"Australian Classification of Health Interventions (ACHI) 8th edition. [cited 21 Jul 2023]. Available: https:\/\/meteor.aihw.gov.au\/content\/514008"},{"key":"pone.0310981.ref023","first-page":"e9308","article-title":"Thirty-Day Hospital Readmissions: A Predictor of Higher All-cause Mortality for Up to Two Years.","volume":"12","author":"JA Shaw","journal-title":"Cureus"},{"key":"pone.0310981.ref024","doi-asserted-by":"crossref","first-page":"f7171","DOI":"10.1136\/bmj.f7171","article-title":"Causes and patterns of readmissions in patients with common comorbidities: retrospective cohort study","volume":"347","author":"J Donz\u00e9","year":"2013","journal-title":"BMJ"},{"key":"pone.0310981.ref025","volume-title":"Healthcare Cost and Utilization Project (HCUP) Statistical Briefs.","author":"PL Owens","year":"2006"},{"key":"pone.0310981.ref026","author":"Independant Hospital Pricing Authority","journal-title":"Pricing and Funding for Safety and Quality."},{"key":"pone.0310981.ref027","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries.","volume":"71","author":"H Sung","year":"2021","journal-title":"CA Cancer J Clin."},{"key":"pone.0310981.ref028","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1111\/j.1464-410X.2012.11122.x","article-title":"The relationship of postoperative complications with in-hospital outcomes and costs after renal surgery for kidney cancer","volume":"111","author":"SP Kim","year":"2013","journal-title":"BJU Int"},{"key":"pone.0310981.ref029","doi-asserted-by":"crossref","first-page":"232","DOI":"10.5489\/cuaj.4397","article-title":"Benchmarking quality for renal cancer surgery: Canadian Kidney Cancer information system (CKCis) perspective.","volume":"11","author":"KA Lawson","year":"2017","journal-title":"Can Urol Assoc J."},{"key":"pone.0310981.ref030","year":"2016","journal-title":"Renal Cancer Clinical Quality Performance Indicators: Engagement Document"},{"key":"pone.0310981.ref031","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1200\/JCO.2020.38.6_suppl.667","article-title":"Hospital-level quality indicators for kidney cancer surgery: A Veteran\u2019s Affairs national health system validation of concept","volume":"38","author":"D Aguilar Palacios","year":"2020","journal-title":"J Clin Oncol"},{"key":"pone.0310981.ref032","doi-asserted-by":"crossref","first-page":"208","DOI":"10.1111\/bju.15650","article-title":"Emergency department visits for radiation cystitis among patients with a prostate cancer history","volume":"130","author":"V Lee","year":"2022","journal-title":"BJU Int"},{"key":"pone.0310981.ref033","doi-asserted-by":"crossref","first-page":"1359","DOI":"10.1016\/S0140-6736(03)13073-5","article-title":"Benign prostatic hyperplasia","volume":"361","author":"A Thorpe","year":"2003","journal-title":"The Lancet"},{"key":"pone.0310981.ref034","doi-asserted-by":"crossref","first-page":"e0147087","DOI":"10.1371\/journal.pone.0147087","article-title":"Incidence and Variation of Discrepancies in Recording Chronic Conditions in Australian Hospital Administrative Data.","volume":"11","author":"H Assareh","year":"2016","journal-title":"PLoS One."}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0310981","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,13]],"date-time":"2024-11-13T18:31:38Z","timestamp":1731522698000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0310981"}},"subtitle":[],"editor":[{"given":"Yudai","family":"Ishiyama","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2024,11,13]]},"references-count":34,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2024,11,13]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0310981","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,13]]}}}