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Background & Aim: Hospital readmissions are defined as multiple inpatient stays within a specified time period by the same
patient (Agency for Healthcare Research and Quality, 2013). Screening is the first step in identifying patients at risk for hospital
readmissions and predicting readmission to the hospital. The study aims to identify, summarize and evaluate readmission
screening tools for older adults.
Method: A systematic review of articles written in English and identified via CINAHL, MEDLINE/PubMed, Ovid UML and
Cochrane Library was conducted. Additional studies were identified by through reference lists of the identified articles and
by Google search. Search items included keywords for readmission, risk assessment, tools and the terms hospital settings
and older adults. Reliability, validity and predictors of readmission tools were extracted independently by two authors and
categorized by the authors classification tool.
Result: 14 studies using five screening tools were identified. Based on the author developed scale screening tools, ISAR, TRST
and hospital score showed low to moderate validity and moderate to good reliability. The RRAT validity and reliability scores
were low to moderate, and the LACE index validity score was low to moderate, but the reliability of the tool was not reported.
Independent variables that were most often identified as predictors of hospital readmission were history of hospital admission,
polypharmacy, cognitive and memory problems, the need for help as well as difficulties in walking, the length of stay and
comorbid conditions.
Conclusion: No single older adult readmission tool stands out as the best hospital readmissions risk screening tool. Tools
can be chosen based on ease of use, predictors and hospital needs. Future studies comparing tools with patients with different
diagnosis should be conducted.