Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2018


Doctor of Nursing Practice (DNP)

Primary Advisor

Ellen T. Kurtzman, PhD, MPH, RN, FAAN; Patricia Robinson, PhD, ARNP, NE-BC, CCRP; Hong Tao, PhD, RN


Background: Unplanned readmissions, within 30 days following an inpatient hospital admission, are common and costly. Research has identified factors that predict readmissions, and predictive algorithms, such as the LACE index, have been studied and widely adopted by hospitals despite demonstrated variability in predictive ability.

Objectives: To examine the associations between unplanned readmissions and the LACE index, and other variables that reflect patient- and encounter-level factors not currently incorporated in the LACE index.

Methods: A retrospective analysis was conducted utilizing data from electronic health records of inpatients discharged from a large quaternary hospital located in the southeastern United States between January 1 and June 30, 2017. Associations between readmissions and each variable were separately examined utilizing chi-square test.

Results: Of the 17,082 inpatients, 1,695 (9.9%) patients were readmitted. Positive, statistically significant associations (p<0.01), were found between readmission and each of the following: LACE index, race, marital status, payer source, index disposition, and index Diagnosis-Related Group (DRG). No association was found with age, gender, or preferred language.

Conclusions: LACE index, race, marital status, payer source, index disposition, and DRG were associated with unplanned readmission. Utilizing other factors, in addition to the LACE index, may be clinically useful in better predicting readmissions and targeting resources to prevent them from occurring.

Open Access




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