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<0.001), while age, ethnicity and deprivation showed no statistically significant association. Primary causes of admission included infections, heart failure and falls. Mortality rates were
notably higher in admitted patients at both 30 and 90 days.
Conclusions: This study confirms the predictive validity of the interRAI DIVERT scale for unplanned hospital admissions among community-dwelling older adults in urban Aotearoa New Zealand. The strong association between higher scores and increased admission rates supports its use in risk-stratification within this population.