SAFE identification of patients at risk for readmission to municipal acute care units

Background: In Norway, municipal acute care units (KAD) is especially targeted at frail older citizens and aims to reduce unnecessary hospitalisation. Like hospital admissions, readmission to KAD is a recurring phenomenon among older people. Early identification of risk factors for readmission will contribute to improved follow-up and more targeted treatment and care. Objective: To assess if and how the Sub Acute Functional decline in the Elderly instrument (SAFE) can identify patients at risk for readmission to KAD. Method: In phase 1, a scoping review was conducted to identify factors characterising frailty in older people and general risk factors for readmission. The findings from phase 1 was synthesized into scoring elements representing risk factors for readmission of frail older people through thematic analysis. In phase 2, a scoring instrument was developed to be able to assess SAFE’s compliance with the scoring elements. Results: Sixty-two scoring elements were identified within the following categories; 1) Patient characteristics (age, sex, medical diagnoses, clinical factors); 2) Pre-per and post hospital admission events; 3) Overall assessments. The degree of compliance with the overall risk factors for readmission was 28%. However, SAFE complied with the clinical factors and overall assessments by 75 and 78%, respectively.