Prediction of unplanned hospital admissions using the interRAI DIVERT scale among community-dwelling older adults in Aotearoa New Zealand

AIM: We aimed to validate the interRAI Detection of Indicators and Vulnerabilities for Emergency Room Trips (DIVERT) scale in predicting unplanned hospital admissions following emergency department (ED) visits among community-dwelling older adults in an urban Aotearoa New Zealand population. METHODS: We conducted a retrospective cohort study of adults aged ≥55 years who underwent interRAI home care (HC) version 9.1 assessment between May 2021 and April 2022. The DIVERT score, derived from HC assessment data, categorised patients into risk levels. Hospital records were reviewed for unplanned hospital admissions via ED within 90 days of assessment. Statistical analyses, including survival and regression models, were used to evaluate predictive validity and explore risk factors. RESULTS: Between May 2021 and April 2022, 2,006 patients were assessed, with a mean age of 79.8 years (range 55-103). Admission rates within 90 days increased with higher DIVERT scores, from 18.2% (score 1) to 41.9% (score 6). Among high-risk groups (scores 5-6), a higher comorbidity burden was significantly associated with admission (p