Healthcare & Clinical
HOSPITAL Score for Potentially Avoidable 30-Day Readmission (0–13)
Calculate Jacques Donzé’s internationally validated HOSPITAL score (0–13 points: Hemoglobin < 12, Oncology, Sodium < 135, Procedure, Urgent Index Type, Prior Admissions, LOS >= 5) before medical discharge.
Targeting POTENTIALLY AVOIDABLE readmissions rather than unavoidable planned hospitalizations!
Many 30-day readmissions (scheduled chemotherapy cycles or staged surgeries) are clinically unavoidable. Jacques Donzé et al. (JAMA Internal Medicine, 2013; 9-country international validation 2016) specifically trained the 0–13 point HOSPITAL mnemonic to predict POTENTIALLY AVOIDABLE 30-day medical readmissions: Hemoglobin at discharge < 12 g/dL (+1), Discharge from an Oncology service (+2), Sodium at discharge < 135 mmol/L (+1), Any ICD-coded Procedure during index stay (+1), Index admission Type urgent/emergent (+1), Number of hospital Admissions in prior 12 months (0–1 = 0, 2–5 = +2, > 5 = +5), and Length of stay >= 5 days (+2)!
Patients stratify cleanly into Low Risk (0–4 points: ~5.8% avoidable readmission), Intermediate Risk (5–6 points: ~11.9%), and High Risk (>= 7 points: ~22.8% potentially avoidable 30-day readmission)!
| HOSPITAL Score Band (0–13 Points) | Avoidable 30-Day Readmission Rate | Discharge Stewardship Action |
|---|---|---|
| 0 – 4 points | 5.8% (Low Risk) | Standard Written Discharge Summary & PCP Handoff |
| 5 – 6 points | 11.9% (Intermediate Risk) | Structured Teach-Back & Post-Discharge Nurse Phone Check |
| >= 7 points (7 – 13) | 22.8% (High Risk) | Pharmacist Med-Rec + 7-Day Bridge Clinic Appointment |
Total Donzé HOSPITAL Readmission Score (0 to 13 Points)
Evaluates discharge Hemoglobin B2 (g/dL), Oncology flag B3 (0/1), discharge Sodium B4 (mmol/L), Procedure + Urgent flags sum B5 (0–2), prior-year admissions count B6, and Length of Stay B7 (days).
=IF(OR(B2 <= 2, B3 < 0, B3 > 1, B4 < 100, B5 < 0, B5 > 2, B6 < 0, B7 < 0), "Invalid HOSPITAL Inputs", IF(B2 < 12, 1, 0) + (2 * B3) + IF(B4 < 135, 1, 0) + B5 + IF(B6 > 5, 5, IF(B6 >= 2, 2, 0)) + IF(B7 >= 5, 2, 0))HOSPITAL Potentially Avoidable Readmission Risk Tier
Classifies total score into Low (0–4), Intermediate (5–6), or High Risk (>= 7).
=IF(OR(B2 <= 2, B3 < 0, B3 > 1, B4 < 100, B5 < 0, B5 > 2, B6 < 0, B7 < 0), "Invalid HOSPITAL Inputs", IF(IF(B2 < 12, 1, 0) + (2 * B3) + IF(B4 < 135, 1, 0) + B5 + IF(B6 > 5, 5, IF(B6 >= 2, 2, 0)) + IF(B7 >= 5, 2, 0) <= 4, "Low Risk (0-4 — 5.8% Avoidable)", IF(IF(B2 < 12, 1, 0) + (2 * B3) + IF(B4 < 135, 1, 0) + B5 + IF(B6 > 5, 5, IF(B6 >= 2, 2, 0)) + IF(B7 >= 5, 2, 0) <= 6, "Intermediate Risk (5-6 — 11.9%)", "High Risk (>=7 — 22.8% Avoidable Readmission)")))Try the example
Use the original values or change them to test your understanding.