Table 1.
Patient Characteristics and Information Extracted from Clinical Notes Between Patients with Hospitalization/ED Visit and those without. For bivariate analysis, student t-tests or Fisher exact tests were used, as appropriate (all p-value < 0.05).
| Patients without hospitalizations/ED visits (N = 69,897) | Patients with hospitalizations/ED visits (N = 9,182) | |
|---|---|---|
| Length of episode (mean: days, SD) | 30.6 (14.1) | 39.9 (17.9) |
| Structured data (OASIS Item): Socio-demographic factor | ||
| Age (mean: years, SD) | 77.9 (11.6) | 78.8 (12.7) |
| Gender: Female [n, (%)] | 44,913 (64.3%) | 5,675 (61.8%) |
| Race/Ethnicity [n, (%)] | ||
| Asian | 3,925 (5.62%) | 411 (4.48%) |
| Black | 11,708 (16.8%) | 1,989 (21.7%) |
| Hispanic | 9,007 (12.9%) | 1,498 (16.3%) |
| White | 44,936 (64.3%) | 5,246 (57.1%) |
| Type of insurance [n, (%)] | ||
| Dual eligibility | 4,009 (5.7%) | 753 (8.2%) |
| Medicare/Medicaid fee-for-service only | 61,362 (87.8%) | 7,659 (83.4%) |
| Any managed care | 3,056 (4.4%) | 595 (6.5%) |
| Other (e.g., private) | 1,446 (2.1%) | 175 (1.9%) |
| Living Condition: Living alone [n, (%)] | 26,979 (38.5%) | 3,599 (39.2%) |
| Structured data (OASIS Item): Medical conditions - Active diagnoses [n, (%)] | ||
| Acute myocardial infarction | 12,618 (18.1%) | 1,957 (21.3%) |
| Arthritis | 17,880 (25.6%) | 1,361 (14.8%) |
| Cardiac dysrhythmias | 10,505 (15.0%) | 1,716 (18.7%) |
| Cancer | 1,000 (1.43%) | 395 (4.30%) |
| Diabetes | 19,325 (27.6%) | 3,421 (37.3%) |
| Dementia | 8,894 (12.7%) | 1,336 (14.6%) |
| Heart failure | 9,019 (12.9%) | 2,198 (23.9%) |
| Hypertension | 45,574 (65.2%) | 6,129 (66.8%) |
| Pulmonary disease | 10,262 (14.7%) | 1,813 (19.7%) |
| Renal failure | 2,277 (3.26%) | 729 (7.94%) |
| Skin ulcer | 6,681 (9.56%) | 1,737 (18.9%) |
| Structured data (OASIS Item): Risk for Hospitalization [n, (%)] | ||
| History of falls in the past 12 months | 14,904 (21.3%) | 2,087 (22.7%) |
| Multiple hospitalizations in the past 6 months | 15,654 (22.4%) | 3,658 (39.8%) |
| Currently taking 5 or more medications | 55,108 (78.8%) | 7,698 (83.8%) |
| Decline in mental, emotional, or behavioral status in the past 3 months | 9,850 (14.1%) | 1,686 (18.4%) |
| Structured data (OASIS Item): Sensory Status [n, (%)] | ||
| Vision impaired | 13,306 (19%) | 2,141 (23.3%) |
| Hearing impaired | 16,195 (23.2%) | 2,417 (26.3%) |
| Difficulty in understanding verbal content | 19,729 (28.3%) | 3,058 (33.3%) |
| Difficulty in verbal expression | 20,724 (29.7%) | 3,424 (37.3%) |
| Having Pain | 53,891 (77.1%) | 6,813 (74.2%) |
| Structured data (OASIS Item): Integumentary Status [n, (%)] | ||
| Having a risk of developing pressure ulcers | 26,833 (38.4%) | 4,486 (48.9%) |
| Having at least one Unhealed Pressure Ulcer at Stage II or Higher | 4,169 (6%) | 1,013 (11%) |
| Having stasis wound | 1,255 (1.8%) | 318 (3.46%) |
| Having surgical wounds | 20,176 (28.9%) | 1,670 (18.2%) |
| Having skin lesion or open wound | 13,015 (18.6%) | 2,416 (26.3%) |
| Structured data (OASIS Item): Elimination [n, (%)] | ||
| Urinary Tract Infection in the past 14 days | 4,457 (6.4%) | 875 (9.5%) |
| Structured data (OASIS Item): Neuro, Emotional, and Behavioral Status [n, (%)] | ||
| Cognitive functioning (i.e., required prompting, assistance or totally dependent) | 8,370 (12%) | 1,490 (16.2%) |
| Structured data (OASIS Item): Overall Status [n, (%)] | ||
| Stable | 4,849 (6.94%) | 542 (5.90%) |
| Likely to be stable | 55,260 (79.1%) | 6,726 (73.3%) |
| Fragile | 9,439 (13.5%) | 1,820 (19.8%) |
| Serious | 349 (0.50%) | 94 (1.02%) |
| Structured data (OASIS Item): ADLs / IADLs | ||
| ADL Needed [mean, (SD)]† | 8.05 (1.52) | 8.24 (1.36) |
| ADL Severity [mean, (SD)]‡ | 15.5 (6.74) | 17.2 (7.51) |
| Unstructured Clinical Notes: Using the Omaha System as a risk factor (Identified through NLP approaches) [n, (%)] | ||
| Abuse | 1,375 (1.97%) | 322 (3.51%) |
| Bowel function | 2,759 (3.95%) | 831 (9.05%) |
| Circulation | 23,108 (33.1%) | 3,842 (41.8%) |
| Cognition | 10,654 (15.2%) | 1,828 (19.9%) |
| Infectious condition | 15,422 (22.1%) | 3,070 (33.4%) |
| Consciousness | 1,492 (2.13%) | 554 (6.03%) |
| Digestion/hydration | 4,798 (6.86%) | 1,097 (11.9%) |
| Genitourinary function | 1,684 (2.41%) | 460 (5.01%) |
| Health care supervision | 6,017 (8.61%) | 864 (9.41%) |
| Medication regimen | 3,311 (4.74%) | 582 (6.34%) |
| Mental health | 21,029 (30.1%) | 3,585 (39.0%) |
| Neglect | 2,153 (3.08%) | 471 (5.13%) |
| Nutrition | 4,674 (6.69%) | 1,092 (11.9%) |
| Neuro musculoskeletal function | 32,143 (46.0%) | 4,112 (44.8%) |
| Pain | 32,414 (46.4%) | 4,595 (50.0%) |
| Respiration | 13,455 (19.2%) | 2,990 (32.6%) |
| Skin | 12,804 (18.3%) | 2,535 (27.6%) |
| Social contact | 12,828 (18.4%) | 1,573 (17.1%) |
| Speech and language | 2,730 (3.91%) | 472 (5.14%) |
| Substance use | 376 (0.54%) | 71 (0.77%) |
Note: SD = standard deviation; OASIS = Outcome and Assessment Information Set; ADLs / IADLs; Activities of Daily Livings/Instrumental Activities of Daily Livings; NLP = natural language processing.
†:
“ADL Needed” which was defined as the summed binary ADL/IADL items (ranging from 0 to 9) derived from ADL items such as grooming, dressing upper and lower, bathing, toileting, transferring, ambulating, and eating, as well as IADL items such as meal preparation. Binary indicator 0 was given if response 0 was given (no issue); otherwise, 1 was given (moderate or significant issue).
‡:
“ADLs Severity” was calculated by totaling the response categories of the dependency level in ADL/IADL items (total ranged from 0 to 38).