Risk Factors for Potentially Avoidable Hospital Admissions and Emergency Department Visits: A Literature Review

Abstract

As part of its participation in the Maryland Primary Care Program (MDPCP), The Hilltop Institute is developing a risk model that will score primary care patients attributed to MDPCP-participating practices according to risk of avoidable hospitalization and/or emergency department (ED) utilization. These patient-level risk scores will ultimately be vended to participating medical practices on a monthly basis in order to facilitate care management through the improved allocation of scarce care coordination resources.

As a first step in this process, Hilltop conducted a comprehensive literature review. The goal of the review was to find peer-reviewed academic journal articles that identify risk factors for potentially avoidable hospitalization, thus providing a basis for risk factor extraction and risk model feature creation. Identified risk factors will be coded using CCLF and other publicly available data sources and included in the final risk model as potential predictors of avoidable hospitalization or ED use. The literature review provides the foundation for the MDPCP risk model and is a crucial step in the modeling process.