Understanding Risk of Hospitalisation (RoH)

Risk of Hospitalisation is a prediction that estimates how likely an inpatient is to return to hospital via the Emergency Department (ED) within 30 days or 60 days of discharge.
It helps clinical and leadership teams plan safe discharges, prioritise follow-up care, and reduce preventable readmissions.

In this article:

How RoH works
Risk categories
Where you'll see RoH in SystemView
Using RoH in practice
Why it matters

How RoH works

RoH combines patient information already available in SystemView, including:

Age
Time since last admission
Current length of stay
Recent ED and outpatient visits
Admission ward
Locality (whether the patient is local to the service)
Maternity-specific factors (where applicable)

From these variables, SystemView calculates a percentage risk of readmission at both 30- and 60-days post discharge. A higher percentage means a higher chance of readmission.

💡Think of RoH as a helpful guide — it highlights patients who may need extra attention, but decisions should always be made using clinical judgement.

Risk categories

RoH scores are colour-coded into three easy-to-read categories — High, Medium, and Low risk — so you can quickly see which patients may need extra attention.
Each patient’s RoH percentage score is calculated for both 30-day and 60-day time frames, and the thresholds differ slightly between the two.

Time Frame	🔴 High Risk	🌕 Medium Risk	🔵 Low Risk
30-day	> 30 %	15 - 30 %	< 15 %
60-day	> 40 %	25 - 40 %	< 25 %

These thresholds are consistent across all SystemView components that display RoH data.

💡A patient may have a low risk of rehospitalisation at 30 days but a medium risk at 60 days; both scores should be considered when planning follow‑up.

Where you’ll see RoH in SystemView

Complex Patients

The Admitted Patient Register, Complex Patient Register, and Complex Patient Escalation List all display RoH data.
You can filter or sort by risk category to identify which patients may require additional discharge planning or post-discharge support.

Ward View

The Ward Demand and Ward Overview components show each patient’s RoH score alongside demographic details and Flow LoS data.
Colour indicators (red = high, amber = medium, green = low) help ward teams quickly assess balance between freeing beds and discharging safely.

Using RoH in practice

1. Support discharge planning
High-risk patients may need enhanced planning such as medication reconciliation, early follow-up appointments, or community referrals.

2. Focus your interventions
Direct post-discharge calls or follow-ups to patients flagged with higher RoH scores for more effective resource use.

3. Monitor daily changes
Because RoH recalculates daily, a rising score may signal new issues delaying discharge. A dropping score often means risk factors are resolving.

4. Interpret in context
RoH supports but does not replace clinical judgement. Always consider clinical stability, social factors, and patient preference when planning discharge

Why it matters

RoH helps teams anticipate readmission risk early, plan safe discharges, and focus support where it’s most needed. It’s a guide to complement clinical judgement — not replace it — helping hospitals balance patient flow, safety, and proactive, patient-centred care.