Rothman Index uses EHR to identify health risks, unplanned readmissions

Researchers evaluated the Rothman Index, a calculator that uses information from electronic health records to identify health risks, and concluded it can be successfully used to predict the likelihood of unplanned hospital readmissions, according to recent research published in Medical Care.

“We know the Rothman Index is associated with readmissions, but we do not know if it can be used to improve decision making at the bedside in terms of when patients are discharged,” Elizabeth H. Bradley, PhD, from the Yale School of Public Health in New Haven, Conn., stated in a press release. “We also don’t know if physicians would benefit from using it as part of determining what kinds of added supports at home and in the community might be arranged at discharge. Answering these questions will determine if the Rothman Index can be used prospectively by clinicians to reduce readmissions and adverse events post-hospitalization.”

According to the release, the Rothman Index was named for two brothers, Michael and Steven Rothman, whose mother died unexpectedly 4 days after being discharged from a hospital following heart surgery. The Rothman Index has a maximum score of 100 points. Patients who score less than 70 points are considered high risk, patients scoring between 70 points to 79 points are considered medium risk, and patients at 80 points or above are low risk, according to the abstract. The index is updated through a patient’s electronic health record (EHR) and regularly checks their Braden score, cardiac rhythms, laboratory test results and vital signs.

Using data from 2,730 patients who were hospitalized during 2011 when physicians did not have access to the Rothman Index, Bradley and colleagues found 16% of patients had unplanned 30-day readmissions. After conducting a multivariate analysis, they noted patients in the high-risk category had a 2.65 higher odds ratio of 30-day readmission compared to the lowest risk patients. Patients in the high-risk category had a readmission rate of 1 in 5 patients compared to patients in the lowest risk category, who had a 1 in 10 patient readmission rate. 


Bradley EH. Medical Care. 2013;doi:10.1097/MLR.0b013e3182a0f492.
Disclosure: The authors have no relevant financial disclosures.