The Adelaide Score: prospective implementation of an artificial intelligence system to improve hospital and cost efficiency

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dc.contributor.authorKovoor, J.G.
dc.contributor.authorStretton, B.
dc.contributor.authorGupta, A.K.
dc.contributor.authorBeath, A.
dc.contributor.authorJacob, M.O.
dc.contributor.authorKefalianos, J.M.
dc.contributor.authorCarmichael, G.J.
dc.contributor.authorZaka, A.
dc.contributor.authorO'Callaghan, G.
dc.contributor.authorSatheakeerthy, S.
dc.contributor.authorBooth, A.
dc.contributor.authorDelloso, T.
dc.contributor.authorHugh, T.J.
dc.contributor.authorChan, W.O.
dc.contributor.authorMaddern, G.J.
dc.contributor.authorBalan-Vnuk, E.
dc.contributor.authorCusack, M.
dc.contributor.authorGilbert, T.
dc.contributor.authorMaddison, J.
dc.contributor.authorBacchi, S.
dc.contributor.authoret al.
dc.date.issued2025
dc.description.abstractBackground: The Adelaide Score is an artificial intelligence system that integrates objective vital signs and laboratory tests to predict likelihood of hospital discharge. Methods: A prospective implementation trial was conducted at the Lyell McEwin Hospital in South Australia. The Adelaide Score was added to existing human, artificial intelligence, and other technological infrastructure for the first 28 days of April 2024 (intervention), and outcomes were compared using parametric, non-parametric and health economic analyses, to those in the first 28 days of April 2023 (control). Artificial intelligence evaluated inpatients admitted under 18 surgical and medical teams, and patients of high likelihood of discharge were provided, on working shifts between Thursday to Sunday, to the Supportive Weekend Interprofessional Flow Team (SWIFT) comprising a senior nurse and pharmacist. Results: Two thousand nine hundred and sixty-eight admissions were included across intervention and control periods. Relative to the control group, use of the Adelaide Score in the intervention group resulted in significantly shorter median length of stay (3.1 versus 2.9 days, P = 0.028) and significantly lower seven-day readmission rate (7.1 versus 5.0%, p = 0.02). The 0.2 bed-day reduction in median length of stay produced a cost saving of $735 708.60 across the 28-day period, or $9 564 211.80 across a 52-week year. There was no significant difference between intervention and control groups in median length of stay for patients discharged on weekends, in-hospital mortality, or discharge to non-home destinations. Conclusions: The prospective implementation of the Adelaide Score was associated with improved hospital and cost efficiency, alongside lower readmissions, for patients across surgical and medical services.
dc.description.statementofresponsibilityJoshua G. Kovoor, Brandon Stretton, Aashray K. Gupta, Alexander Beath, Mathew O. Jacob, John M. Kefalianos, Gavin J. Carmichael, Ammar Zaka, Gerry O, Callaghan, Shrirajh Satheakeerthy, Andrew Booth, Thomson Delloso, Thomas J. Hugh, Weng Onn Chan, Guy J. Maddern, Eva Balan-Vnuk, Michael Cusack, Toby Gilbert, John Maddison, Stephen Bacchi, and on behalf of the Adelaide Score Advisory Group (Adelaide Score Advisory Group: Amal Abou-Hamden ... Matthew Arnold ... Markus Trochsler ... Anton Van Den Hengel ... Andrew Zannettino ... et al.)
dc.identifier.citationANZ Journal of Surgery, 2025; 95(3):342-349
dc.identifier.doi10.1111/ans.19383
dc.identifier.issn1445-1433
dc.identifier.issn1445-2197
dc.identifier.orcidKovoor, J.G. [0000-0002-3880-3840]
dc.identifier.orcidStretton, B. [0000-0002-7939-3489]
dc.identifier.orcidGupta, A.K. [0000-0002-8038-0378]
dc.identifier.orcidCarmichael, G.J. [0009-0009-2143-3896]
dc.identifier.orcidSatheakeerthy, S. [0009-0005-8604-3750]
dc.identifier.orcidBooth, A. [0009-0005-0023-6552]
dc.identifier.orcidGilbert, T. [0000-0002-3431-9672]
dc.identifier.orcidMaddison, J. [0000-0001-8692-8878]
dc.identifier.orcidBacchi, S. [0000-0001-5130-8628]
dc.identifier.urihttps://hdl.handle.net/2440/144722
dc.language.isoen
dc.publisherWiley
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/2004036
dc.rights© 2025 The Author(s). ANZ Journal of Surgery published by John Wiley & Sons Australia, Ltd on behalf of Royal Australasian College of Surgeons
dc.source.urihttps://doi.org/10.1111/ans.19383
dc.subjectAdelaide Score Advisory Group
dc.subjectartificial intelligence; cost saving; efficiency; the Adelaide score
dc.subject.meshHumans
dc.subject.meshProspective Studies
dc.subject.meshArtificial Intelligence
dc.subject.meshMale
dc.subject.meshFemale
dc.subject.meshSouth Australia
dc.subject.meshMiddle Aged
dc.subject.meshAged
dc.subject.meshLength of Stay
dc.subject.meshPatient Discharge
dc.subject.meshCost-Benefit Analysis
dc.subject.meshPatient Readmission
dc.titleThe Adelaide Score: prospective implementation of an artificial intelligence system to improve hospital and cost efficiency
dc.typeJournal article
pubs.publication-statusPublished

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