AIMS: Reducing potentially avoidable hospital readmissions has been the target 
of several healthcare initiatives, including the readmission prevention team 
(RAPT) at Western Health, Melbourne. Study aims were to evaluate if the revised 
LACE (length of stay, acuity of admission, Charlson Comorbidity Index, emergency 
department visits in the past 6 months) index would identify high risk of early 
readmission (≤30 days postdischarge), and if postdischarge clinic and community 
services follow-up would reduce readmission rate.
METHODS: A prospective study was conducted among all general medicine inpatients 
within a tertiary hospital in Melbourne, Australia between February to April 
2016, with risk screening using the revised LACE index, alongside abbreviated 
mental test and clinical frailty scale testing, with high-risk patients (revised 
LACE ≥ 8) offered specialist clinic appointment and/or referral to community 
services.
RESULTS: Among 781 patients (873 admission episodes), 358 (41.0%) admission 
episodes were classified as high risk of early readmission. Revised LACE index 
scores were equivalent for readmission vs. non-readmission episodes, {median 7 
[interquartile range (IQR) 5, 8] vs. 7 [IQR 4, 8])}, as were median abbreviated 
mental test (8 [IQR 6, 9] vs. 8 [IQR 6, 9]) and clinical frailty scale scores (5 
[IQR 3, 6] vs. 5 [IQR 3, 6]). Early readmission rates were equivalent for those 
who received compared with did not receive RAPT intervention (14.3 vs. 14.7%), 
albeit confounded by lack of identification of readmission risk using the 
revised LACE index. A total of 53 (14.8%) of the 358 high-risk admission 
episodes formally declined RAPT follow-up.
CONCLUSION: This study highlighted the complexities of addressing hospital 
readmissions, with challenges in identifying those at risk, and low uptake and 
impact of current intervention strategies. Future research directions may 
evaluate other contributors to readmission risk, and the development of 
acceptable postdischarge interventions to effectively address risk.