Table 1. Characteristics of questionnaires or screening tools.

Tool and references	Authors, year and country of first article about the tool	Characteristics of population screened by the tool	Outcome	Format of the tool	Dimensions or number of questions evaluated by the tool	Time needed
Probability of Repeated Admission (Pra)[13–22]	1. Boult, C. 2. Dowd, B. 3. McCaffrey, D. 4. Boult, L. 5. Hernandez, R. 6. Krulewitch, H. 1993, USA	Elderly persons 65 years or older	Probability of an elderly person being hospitalized within 4 years	Post or telephone interview	1. Availability of a caregiver 2. Diabetes 3. Age 4. History of coronary artery disease 5. Hospital admission during the past year 6. Gender 7. More than 6 physician visits during the past year 8. Poor self-rated general health Total: 8 questions	5 minutes
Triage Risk Screening Tool (TRST) [23–25]	7. Mion, L.C. 8. Palmer, R.M. 9. Anetzberger, G.J. 10. Meldon, S. W. 1997, USA	Community-dwelling elders (65 years and older)	EmergencyDept. (ED) revisits, hospitalizations, or long-term care placement within 30 and 120 days after an ED visit	Nurse screened all eligible patients	1. Cognitive impairment 2. Self-reported difficulty in walking or transferring 3. Use of 5 or more medications 4. ED visit within the previous 30 days or a hospital admission within the previous 90 days 5. ED Registry nurse recommendations Total: 5 questions	Not reported. Estimated: 5 minutes
“Initial assessment interview question”[20]	11. Boult, C. 12. Pualwan, T.F. 13. Fox, P.D. 14. Pacala, J.T. 1998, USA	Seniors	High-risk seniors likely to benefit from multidimensional intervention	Telephone or in-person interview	8 domains: 1. Cognition (4 questions) 2. Medical conditions (3 questions per health problem) 3. Medications (4 questions) 4. Access to care (8 questions) 5. Functional status (8 questions) 6. Social situation (3 questions) 7. Nutrition (minimum 1 question if no weight change, maximum of 3 questions) 8. Emotional status (2 questions) Minimum number of questions: 33; Maximal number of questions: relative to the number of health problems and change of weight	30–45 minutes
INTERMED [26–33]	15. Huyse, FJ.1 16. Lyons, JS. 17. Stiefel, FC. 18. Slaets, JP. 19. de Jonge, P. 20. Fink, P. 21. Gans, RO. 22. Guex, P. 23. Herzog, T. 24. Lobo, A. 25. Smith, GC. 26. van Schijndel, RS. 1999 *, Netherlands *	(No age specifications)	Indicates bio-psychosocial health-care needs. The higher the score the higher the healthcare needs *	Observer-rated instrument	1. Biological: Chronicity and diagnostic uncertainty (history)/Severity of illness and clarity of diagnostic profile (current state) /Complications and life threat (short- and long-term) (prognosis) 2. Psychological: Restrictions in coping, premorbid level of psychiatric dysfunctioning (history)\Treatment resistance, severity of psychiatric symptoms (current state)\ Mental health threat (short- and long-term) (prognosis) 3. Social: Family disruption, impairment of social support (history) \Residential instability, impairment of social integration (current state)\Social vulnerability (short- and long-term) (prognosis) 4. Healthcare system: Intensity of prior treatment, prior treatment experience (history)\ Organizational complexity at admission or referral, appropriateness of admission or referral (current state) \Care needs (short- and long-term) (prognosis) Total: 20 questions [30]	20–30 minutes (at least) *
Community Assessment Risk Screen (CARS)[19, 34]	5. Shelton, P. 6. Sager, M.A. 7. Schreaeder, C. 2000, USA	Patients 65 years and older	Patients at risk of hospitalization or having an ED encounter during the subsequent 12 months [34]	Questionnaire filled out by medical staff through an interview or filled by post	1. Preexisting chronic diseases 2 or more (heart disease, diabetes, myocardial infarction, stroke, chronic obstructive pulmonary disease, cancer) 2. Prescription for 5 or more medications 3. Hospitalization or ED use in the preceding 6 months Total: 3 questions[34]	Not reported. Estimated: less than 5 minutes
Analysis of risk element/origin/resources/action(ARORA)[15]	8. Smith, T. 2000, USA	Geriatric patients	Individuals at risk for hospitalization[15]	Two phases: 1) Worksheet completed by medical staff. 2) Algorithm that provides a systematic approach for intervention	7 risk elements: 1. Cognitive function 2. Medical conditions 3. Medications 4. Care access 5. Functional status 6. Nutrition 7. Emotional status For each risk element, there are these 6 questions to answer: 1. Adequate access to medical care 2. Coordination of medical care 3. Patient awareness of all medical needs 4. Patient awareness of self-care needs 5. Presence of mechanical or physical hazards 6. Adequate assistance for self-care Total: 42 questions	Not reported. Estimated: more than 30 minutes
Health Perception Assessment (HPA) Instrument, later named One Care Street Health Profile [35]	- Meek, J. A. - Lyon, B. L. - May, F. E. - Lynch, W. D. 2000, USA	Non-institutionalized enrollees of the health plan, ranging in age from 18 to 65 years old	High use of the healthcare system over the next 6 months	Self-reported mailed questionnaire	1. Physical symptoms 2. Levels of emotions 3. Levels of functioning 4. Beliefs / preferences regarding the healthcare system 5. Health risk 6. Disease 7. Compliance 8. Demographic items (The number of questions per dimension evaluated was not mentioned) Initial version: 70 questions with 126 responses. Shortened version after trial of the predictive model: 48 questions with 74 responses	Not reported. Estimated: more than 30 minutes
Reuben et al. [16]	- Reuben, D. B. - Keeler, E. - Seeman, T. E. - Sewall, A. - Hirsch, S. H. - Guralnik, J. M. 2002, USA	Beneficiaries aged 71 years and older	Patients at high risk for high health care utilization (defined as ≥11 hospital days over 3 years)	Two phases: 1) Self-report by mail, telephone, or possibly, Internet survey. 2) Laboratory tests	First phase: (4 of the 8 Pra questions). 1. Hospitalizations in previous year 2. Hospitalizations in last two years 3. Gender 4. Self-reported health 5. Employment 6. Participation at religious services 7. Need help with bathing 8. Mobility (unable to walk ½ mile) 9. Diabetes 10. Medication (loop diuretic) Second phase: 2 laboratory tests 1. Serum albumin (<3.8 g/dL) 2. Serum iron (<48 mcg/dL) Total: 10 questions and 2 laboratory tests	Not reported. Estimated: 10–15 minutes (without laboratory tests)
Annual screening questionnaire [36]	- Graves, T. - Slater, M.A. - Maravilla, V. - Reissler,L. - Faculjak, P. - Newcomer, R.J. 2003, USA	80 years and older	Overall risk score: high priority, medium, or low	Mailed questionnaire	1. Cognitive/affective 2. Disease 3. Financial/legal 4. Functional status 5. Home environment/safety 6. Lifestyle 7. Medication 8. Nutrition 9. Social/cultural 10. Services utilization (number of questions per domains not mentioned) Total: 85 questions	30–45 minutes
Predicted Insurance Expenditures (Pie) [37]	- Boult, C. - Kessler, J. - Urdangarin, C. - Boult, L. - Yedidia, P. 2004, USA	Full-time adult (21–64 years old) employees with insurance coverage	Heavy users of healthcare services	Short self-report survey scored electronically	Two demographic variables: 1. Advanced age (50 years old and more) 2. Gender Five medical variables: 1. Arthritis causing pain most days 2. High cholesterol 3. Diabetes 4. Cancer 5. Regular use of medication One use-of-services variable: 6. Hospitalization more than 1 time in the previous year 7. Clinic/physician visits more than 3 times in previous year 8. ED visit more than 1 time in previous year Clinic or physician visits more than 1 time during the previous year Total: 8 questions	1–2 minutes
INTERMED for the Elderly (IM-E) [26, 38]	- Söllner, W. - Wild, B. - Lechner, S. - Holzapfel, N. - Slaets, J. - Stiefel, F. - Huyse, F. * 2008 *, Germany*	Elderly patients	Bio-psychosocial healthcare needs*	A highly structured interview* and scoring guide that was recorded in a standardized blank form	(modifications of INTERMED) 1. Biological - Chronicity and diagnostic dilemma (history) - Severity of symptoms, diagnostic problems (current state) - Complications and life threat (prognosis) 2. Psychological - Restrictions in coping psychiatric dysfunctioning (history) - Treatment resistance, psychiatric symptoms (current state) - Mental health threat (prognosis) 3. Social - Restriction in social integration, social dysfunctioning (history) - Residential instability (current state) - Social vulnerability (prognosis) 4. Healthcare system - Intensity of treatment, treatment experience (history) - Complexity of care, appropriateness of care (current state) Coordination of care (prognosis) Total: 20 questions	20–30 minutes (at least)*
INTERMED Self-Assessment (IM-SA) [39]	- Slaets, J. - Stiefel, F. - Ferrari, S. - Huyse, F. - Latour, C. - Boenink, A. - Söllner, W. - Wild, B. * 2008–2010, developed in English; translated into Italian, Spanish, French, Dutch, German *, The Netherlands*	Various patient populations	Bio-psychosocial healthcare needs and the higher the score the higher the healthcare needs	Self-assessment questionnaire	26 questions to be assessed regarding four dimensions: 1. Biological 2. Psychological 3. Social 4. Healthcare use (same domains evaluated as INTERMED original version)	10–12 minutes*
Homeless Screening Risk of Re-Presentation [40]	- Moore, G. - Hepworth, G. - Weiland, T. - Manias, E. - Gerdtz, M.F. - Kehaler, M. - Dunt, D. 2012, Australia	Homeless people who went to the ED	Re-presentation to the ED within 28 days of discharge from hospital	Risk screening tool administered by clerical staff upon presentation to the ED	1. Age group 2. Known next of kin 3. Pensioner (yes/no) 4. Primary presenting problem (medical/surgical, injury, mental illness, drug and alcohol) 5. Number of medical issues (3 or less, 4 to 7, 10 to 14, 15 and more) 6. Number of medications prescribed (4 or less, 5 to 9, 10 to 14, 15 or more) 7. Community support 8. Presented to other hospitals within the last 12 months 9. Discharge outcomes (admit, return to ward, home, ED admit, transferred, left before treatment, residential care facilities) Total: 9 questions	Not reported. Estimated: 5 minutes
INTERMED for the Elderly Self Assessment (IM-E-SA)* [41, 42]	- Peters, L.L. - Boter, H. - Slaets, J.P.J. - Buskens, E.* 2013*, The Netherlands*	Patients 65 years of age and older	Curative care costs in the follow-up year[41]	Self-assessment version [42]	Same as IM-E: the IM-E-SA assesses case complexity and healthcare needs in the following domains: 1. Biological 2. Psychological 3. Social 4. Healthcare All domains comprise five questions, with each domain begin assessed in the context of time (history, current state, and prognosis). Total: 20 questions	15 minutes *

* Information obtained by contacting authors.