The LACE Index – Using Predictive Analytics to Reduce Readmissions

What is the LACE Index?

The Ottawa Hospital Research Institute, along with other contributors, published an article in the Canadian Medical Association Journal; the researchers were attempting to create an easy-to-use index to quantify the risk of readmission after discharge from hospital that would help clinicians identify patients who might benefit from more intensive post-discharge care. The researchers formulated an algorithm called the LACE Index that uses variables commonly available to clinicians. The algorithm computes a score that correlates to the probability of unplanned readmission within 30 days; this probability allows hospitals better utilize their resources by focusing them on patients who are at higher risk for readmission.

How do hospitals use the LACE Index?

The most effective way to reduce readmissions is early planning. Hospitals use the LACE Index to identify current patients who are at high risk for readmission to execute an intervention plan to reduce the risk of readmission.

Since hospitals generally don’t code concurrently, the patient’s previously known comorbidities are used in the calculation.

Computing a LACE Index Score

The LACE acronym stands for Length of Stay, Acuity of Admission, Comorbidity and Emergency visits in the previous six months. The score is calculated using this algorithm.

Note: Comorbidities: The Charlson comorbidity index score was calculated using 1 point for history of myocardial infarction, peripheral vascular disease, cerebrovascular disease or diabetes without complications; 2 points for congestive heart failure, chronic obstructive pulmonary disease, mild liver disease or cancer; 3 points for dementia or connective tissue disease; 4 points for moderate to severe liver disease or HIV infection; and 6 points for metastatic cancer. 

Correlating LACE Index Score to Probability of Readmission

An acute inpatient visit’s score will range between 0 and 19 which correlates to an expected probability of readmission risk or death.