Differential behaviour of a risk score for emergency hospital admission by demographics in Scotland—A retrospective study

Thoma, Ioanna; Rogers, Simon; Ireland, Jillian; Porteous, Rachel; Borland, Katie; Vallejos, Catalina A; Aslett, Louis J M; Liley, James

Abstract

The Scottish Patients at Risk of Re-Admission and Admission (SPARRA) score predicts individual risk of emergency hospital admission for approximately 80% of the Scottish population. It was developed using routinely collected electronic health records, and is used by primary care practitioners to inform anticipatory care, particularly for individuals with high healthcare needs. We comprehensively assess the SPARRA score across population subgroups defined by age, sex, ethnicity, socioeconomic deprivation, and geographic location. For these subgroups, we consider differences in overall performance, score distribution, and false positive and negative rates, using causal methods to identify effects mediated through age, sex, and deprivation. We show that the score is well-calibrated across subgroups, but that rates of false positives and negatives vary widely, mediated by various causes including variability in demographic characteristics, admission reasons, and potentially differential data availability. Our work assists practitioners in the application and interpretation of the SPARRA score in population subgroups.

Citation

Thoma, I., Rogers, S., Ireland, J., Porteous, R., Borland, K., Vallejos, C. A., Aslett, L. J. M., & Liley, J. (2024). Differential behaviour of a risk score for emergency hospital admission by demographics in Scotland—A retrospective study. PLoS Digital Health, 3(12), Article e0000675. https://doi.org/10.1371/journal.pdig.0000675

• Journal Article Type: Article
• Acceptance Date: Oct 21, 2024
• Online Publication Date: Dec 17, 2024
• Publication Date: Dec 17, 2024
• Deposit Date: Oct 21, 2024
• Publicly Available Date: Jan 6, 2025
• Journal: PLOS Digital Health
• Electronic ISSN: 2767-3170
• Publisher: Public Library of Science
• Peer Reviewed: Peer Reviewed
• Volume: 3
• Issue: 12
• Article Number: e0000675
• DOI: https://doi.org/10.1371/journal.pdig.0000675
• Public URL: https://durham-repository.worktribe.com/output/2978302