For healthcare professionals
HOSPITAL score calculator
The HOSPITAL score estimates the risk that an adult leaving a medical ward is readmitted within 30 days, from seven items known at discharge. This tool is written for clinicians planning discharge and follow-up. It is not a self-check and not a diagnosis.
Findings at discharge
For an adult being discharged from a medical service, using the last hemoglobin and sodium before discharge. Nothing you enter leaves this page.
What you will see
The total HOSPITAL score from 0 to 13, the points for each item, the risk group and the readmission risk given for that group.
Educational only, not medical advice. A score never replaces the judgment of the treating team.
Source
The HOSPITAL score by Donzé and colleagues, JAMA Internal Medicine 2013, with the items and points as printed in Table 1 of the open access study by Robinson, PeerJ 2016 (CC BY 4.0), and the risk groups as given in its Methods. The same table appears in Robinson and Hudali, PeerJ 2017. The tests check each item, the hemoglobin, sodium, admission and length of stay edges, the maximum of 13 and the group for the edge scores.
Validated in
The score was built to predict potentially avoidable readmission within 30 days in adults discharged from medical services. We cite the 2013 paper but do not quote it, because its license does not allow reuse here. Robinson tested it for all-cause readmission in 931 discharges from a medical hospitalist service at a 507-bed community hospital in the United States.
Limits
For adults leaving a medical ward, not for surgical, obstetric or pediatric stays. The 5%, 10% and 20% figures are rounded group risks taken from the original validation study, not a prediction for one patient, and readmission rates differ between hospitals and health systems. The score counts readmissions it can see; a readmission to another hospital may be missed. A hemoglobin of 12 g/dL and a sodium of 135 mEq/L do not count; a stay of 5 days counts. Robinson's tables label high risk as 'more than 5' (2016) and '5 or more' (2017), which differs from the 7 or more group in the Methods; this tool uses the 0 to 4, 5 to 6 and 7 or more groups.
The point table
HOSPITAL score, as printed in Robinson 2016 (Robinson 2016) (Donzé 2013):
- Hemoglobin at discharge under 12 g/dL: 1
- Discharge from an Oncology service: 2
- Sodium at discharge under 135 mEq/L: 1
- Procedure during the hospital stay (ICD-10 coded): 1
- Index admission Type urgent or emergent: 1
- Number of hospital Admissions during the previous year: 0 to 1 scores 0, 2 to 5 scores 2, more than 5 scores 5
- Length of stay 5 days or more: 2
The total ranges from 0 to 13. Worked example: a patient with a hemoglobin of 11.4 g/dL (1), not on an oncology service (0), a sodium of 138 mEq/L (0), an endoscopy during the stay (1), admitted through the emergency department (1), with 3 admissions in the previous year (2) and a stay of 6 days (2) scores 7, the high risk group.
Risk groups
Robinson 2016 grouped the scores as given by the original validation study (Robinson 2016):
- Low risk, score 0 to 4: about 5% risk of readmission
- Intermediate risk, score 5 to 6: about 10%
- High risk, score 7 or more: about 20%
In Robinson's cohort, 109 of 931 discharges (12%) were readmitted to the same hospital within 30 days, and the score had a C statistic of 0.77 (Robinson 2016). In a second cohort at the same hospital, 35 of 432 discharges (8%) were readmitted, with a C statistic of 0.75 for the HOSPITAL score and 0.58 for the LACE index (Robinson 2017).
Reading the result
In a prospective Swiss study of 934 medical inpatients, the original HOSPITAL score had an area under the curve of 0.66 for readmission or death within 30 days, with an optimal cut-point of 5 or more (Mathys 2024). The same study tested a simplified version that drops the procedure item, uses 8 days or more for the stay and allows hemoglobin and sodium taken at admission, so that the risk can be estimated earlier in the stay; it performed about the same (Mathys 2024). This calculator uses the original version. A high score points to patients who may benefit most from careful discharge planning and early follow-up; it does not say which patient will come back.
Related tools
For the burden of long-term illness behind many readmissions, see the Charlson comorbidity index. For frailty in older adults, see the FRAIL scale, and for fall risk on the ward, the Morse fall scale. Other bedside scores are listed under For healthcare professionals.
Sources
- Robinson R. The HOSPITAL score as a predictor of 30 day readmission in a retrospective study at a university affiliated community hospital. PeerJ. 2016;4:e2441. doi:10.7717/peerj.2441. PMID 27651999. Open access (CC BY 4.0). pmc.ncbi.nlm.nih.gov/articles/PMC5018668/
- Robinson R, Hudali T. The HOSPITAL score and LACE index as predictors of 30 day readmission in a retrospective study at a university-affiliated community hospital. PeerJ. 2017;5:e3137. doi:10.7717/peerj.3137. PMID 28367375. Open access (CC BY 4.0). pmc.ncbi.nlm.nih.gov/articles/PMC5374974/
- Donzé J, Aujesky D, Williams D, Schnipper JL. Potentially avoidable 30-day hospital readmissions in medical patients: derivation and validation of a prediction model. JAMA Intern Med. 2013;173(8):632-638. doi:10.1001/jamainternmed.2013.3023. PMID 23529115. doi.org/10.1001/jamainternmed.2013.3023
- Mathys P, Bütikofer L, Genné D, et al. The Early HOSPITAL Score to Predict 30-Day Readmission Soon After Hospitalization: a Prospective Multicenter Study. J Gen Intern Med. 2024;39(5):756-761. doi:10.1007/s11606-023-08538-0. PMID 38093025. Open access (CC BY 4.0). pmc.ncbi.nlm.nih.gov/articles/PMC11043245/
Written and maintained by the uncovermyrisk.com editorial team. We do not have a medical reviewer; every claim links to its primary source above. Last reviewed: 2026-11-03. Spotted an error? See About.