Readmission Risk Pool Platform

Provides the R implementation of the Readmission Risk Pool (RRP) analytical platform for reassessing the remaining probability of a first hospital readmission through 30 days after discharge. Distributed as the 'readmit' package, it creates user-owned projects, applies shared eligibility rules at explicit assessment times, retains completed assessments as history, and generates CSV analytical products for a project-owned interactive application. Project authors supply clinical source-mapping and risk-provider functions; no clinically validated prediction model is included.

Readmission Risk Pool

Hospital readmission risk can change after discharge as time passes and new information becomes available. A prediction made only at discharge cannot show how the remaining risk evolves during follow-up.

Readmission Risk Pool (RRP) is an analytical platform for reassessing that risk at chosen times and retaining what each assessment found. readmit is the R package used to create and operate an organization’s RRP project.

How RRP works

For an episode still within follow-up and without a readmission or death by the assessment time, each risk estimate concerns the remaining probability of a first hospital readmission strictly after the assessment time and through 30 elapsed days after the original discharge. The endpoint stays fixed; another assessment does not start a new 30-day window. readmit uses when a supplied readmission or death occurred to decide whether the episode is still eligible. An event occurring by the assessment time removes it from the current risk pool. The project’s risk provider may use predictor information available at that time.

Repeated assessments retain accepted estimates, provider failures, and ineligible episodes in project history. This history shows what was assessed at each time rather than only the latest result.

What the platform provides

An RRP project is an ordinary, organization-owned directory with configuration, source-mapping and risk-provider scripts, and its own Shiny application. readmit defines canonical inputs for discharge episodes and terminal events, applies shared eligibility rules, retains completed assessments, and derives three analytical products: current remaining risk, recorded risk trajectories, and an operational summary. The project application explores those products.

Get started

readmit 1.0.0 is available on CRAN. Install the RRP package with:

install.packages("readmit")

The corresponding GitHub v1.0.0 release provides the release source and notes. Version 1.0.0 substantially changes the earlier 0.0.1 functionality and uses Apache License 2.0.

Choose a new project path whose parent directory already exists:

library(readmit)

project <- rrp_project_init(
  path = "my-rrp-project",
  project_id = "my-project"
)
rrp_project_validate(project)

The initializer creates editable project guidance, configuration, branding, two authoring scripts, and a Shiny app. The scripts start as deliberate stubs. Validation checks that the structure and functions load; it does not run them or establish that assessments are ready.

Using an RRP project

Implement R/produce-canonical.R to map your source data to the required discharge episodes and terminal events, and R/calculate-risk.R to provide risk estimates for eligible episodes. The source mapper supplies episodes discharged by the assessment time; readmit rejects a later discharge before running eligibility or the risk provider. rrp_state_init(project) creates persistent history and rrp_project_status(project) reports project state; both can be used before those scripts are implemented. Once they work, rrp_run(project, as_of_time) records an assessment at a specified UTC time. Use rrp_inspect_history(project) to examine retained results after state initialization, and rrp_refresh_products(project) to derive products after at least one completed run. Refresh does not run another assessment.

The application can open before products exist and will show empty views. Install its runtime packages (shiny, bslib, reactable, plotly, and yaml), then launch it with shiny::runApp(file.path(project, "app")). After a product refresh, the app reads the generated products.

Responsibilities and documentation

Your organization supplies source mapping and a risk provider, evaluates whether its data and model are suitable for the intended use, and decides how results inform clinical or operational decisions. readmit supplies the analytical structure around those inputs; it does not include a clinically validated prediction model or establish that using RRP improves outcomes.

For function reference, use help(package = "readmit") after installation. Each generated project’s README.md explains the canonical contract, risk provider, and application in more detail.