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National Healthcare Agreement: PI 18-Selected potentially preventable hospitalisations, 2015

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termProgress measure
Short name:Help on this termPI 18-Selected potentially preventable hospitalisations, 2015
METeOR identifier:Help on this term559032
Registration status:Help on this termHealth, Superseded 08/07/2016
Description:Help on this term

Admission to hospital for a condition where the hospitalisation could have potentially been prevented through the provision of appropriate individualised preventative health interventions and early disease management usually delivered in primary care and community-based care settings (including by general practitioners, medical specialists, dentists, nurses and allied health professionals).

For example, hospitalisations for conditions such as measles and tetanus can be prevented by primary health care through vaccination to prevent the conditions from occurring. Hospitalisations for patients presenting with acute pharyngitis can be prevented through timely treatment in primary health care settings using antibiotics, and hospitalisations for diabetes complications can be prevented through appropriate, long-term management of diabetes by primary and community health practitioners.

The above definition excludes conditions that are preventable predominately through population health interventions, such as those for clean air and water.

Indicator set:Help on this termNational Healthcare Agreement (2015) Health, Superseded 08/07/2016
Outcome area:Help on this termPrimary and Community Health Health, Standard 07/07/2010
Quality statement:Help on this termNational Healthcare Agreement: PI 18-Selected potentially preventable hospitalisations, 2015 QS Health, Superseded 08/07/2016

Collection and usage attributes

Computation description:Help on this term

Note that the codes below are ICD-10-AM 7th edition.

Table 1: ICD-10-AM, 7th edition codes used for identifying potentially preventable hospitalisations
Category ICD-10-AM codes ICD-10-AM description Additional requirements
Vaccine preventable conditions
Pneumonia and influenza (vaccine-preventable) J10 Influenza due to other identified influenza virus

In any diagnosis.

Exclude people under 2 months.

J11 Influenza, virus not identified

In any diagnosis.

Exclude people under 2 months.

J13 Pneumonia due to Streptococcus pneumoniae

In any diagnosis.

Exclude people under 2 months.

J14 Pneumonia due to Haemophilus influenza

In any diagnosis.

Exclude people under 2 months.

Other vaccine-preventable conditions A08.0 Rotaviral enteritis In any diagnosis.
A35 Other tetanus In any diagnosis.
A36 Diphtheria In any diagnosis.
A37 Whooping cough In any diagnosis.
A80 Acute poliomyelitis In any diagnosis.
B01 Varicella [chicken pox] In any diagnosis.
B05 Measles In any diagnosis.
B06 Rubella [German measles] In any diagnosis.
B16.1 Acute hepatitis B with delta-agent (coinfection) without hepatic coma In any diagnosis.
B16.9 Acute hepatitis B without delta-agent and without hepatic coma In any diagnosis.
B18.0 Chronic viral hepatitis B with delta-agent In any diagnosis.
B18.1 Chronic viral hepatitis B without delta-agent In any diagnosis.
B26 Mumps In any diagnosis.
G00.0 Haemophilus meningitis In any diagnosis.
Chronic
Asthma J45 Asthma

As principal diagnosis.

Exclude children aged less than 4 years.

J46 Status asthmaticus

As principal diagnosis.

Exclude children aged less than 4 years.

Congestive cardiac failure I50 Heart failure

As principal diagnosis.

Exclude cases with the following cardiac procedure codes:

Blocks 600-606, 608-650, 653-657, 660-664, 666, 669-682, 684-691, 693, 705-707, 717 and codes 33172-00[715], 33827-01[733], 34800-00[726], 35412-00[11], 38721-01[733], 90217-02[734], 90215-02[732].

I11.0 hypertensive heart diseased with (congestive) heart failure

As principal diagnosis.

Exclude cases with the following cardiac procedure codes:

Blocks 600-606, 608-650, 653-657, 660-664, 666, 669-682, 684-691, 693, 705-707, 717 and codes 33172-00[715], 33827-01[733], 34800-00[726], 35412-00[11], 38721-01[733], 90217-02[734], 90215-02[732].

J81 Pulmonary oedema

As principal diagnosis.

Exclude cases with the following cardiac procedure codes:

Blocks 600-606, 608-650, 653-657, 660-664, 666, 669-682, 684-691, 693, 705-707, 717 and codes 33172-00[715], 33827-01[733], 34800-00[726], 35412-00[11], 38721-01[733], 90217-02[734], 90215-02[732].

Diabetes complications E10.0–E10.9 Type 1 diabetes mellitus As principal diagnosis.
E11.0–E11.9 Type 2 diabetes mellitus As principal diagnosis.
E13.0–E13.9 Other specified diabetes mellitus As principal diagnosis.
E14.0–E14.9 Unspecified diabetes mellitus As principal diagnosis.
COPD J20 Acute bronchitis

As principal diagnosis.

Only with additional diagnoses of J41, J42, J43, J44.

J41 Simple and mucopurulent chronic bronchitis

As principal diagnosis.

J42 Unspecified chronic bronchitis

As principal diagnosis.

J43 Emphysema

As principal diagnosis.

J44 Other chronic obstructive pulmonary disease

As principal diagnosis.

Bronchiectasis J47 Bronchiectasis

As principal diagnosis.

J20 Acute bronchitis

As principal diagnosis.

Only with additional diagnosis of J47.

Angina I20 Angina pectoris

As principal diagnosis.

Exclude cases according to the list of procedures excluded from the Congestive cardiac failure category above.

I24.0 Coronary thrombosis not resulting in myocardial infarction

As principal diagnosis.

Exclude cases according to the list of procedures excluded from the Congestive cardiac failure category above.

I24.8 Other forms of acute ischaemic heart disease

As principal diagnosis.

Exclude cases according to the list of procedures excluded from the Congestive cardiac failure category above.

I24.9 Acute ischaemic heart disease, unspecified

As principal diagnosis.

Exclude cases according to the list of procedures excluded from the Congestive cardiac failure category above.

Iron deficiency anaemia D50.1 Sideropenic dysphagia As principal diagnosis.
D50.8 Other iron deficiency anaemias As principal diagnosis.
D50.9 Iron deficiency anaemia, unspecified As principal diagnosis.
Hypertension I10 Essential (primary) hypertension

As principal diagnosis.

Exclude cases with procedure codes according to the list of procedures excluded from the Congestive cardiac failure category above.

I11.9 Hypertensive heart disease without (congestive) heart failure

As principal diagnosis.

Exclude cases with procedure codes according to the list of procedures excluded from the Congestive cardiac failure category above.

Nutritional deficiencies E40 Kwashiorkor As principal diagnosis.
E41 Nutritional marasmus As principal diagnosis.
E42 Marasmic kwashiorkor As principal diagnosis.
E43 Unspecified severe protein-energy malnutrition As principal diagnosis.
E55.0 Rickets, active As principal diagnosis.
E64.3 Sequelae of rickets As principal diagnosis.
Rheumatic heart diseases I00 Rheumatic fever without mention of heart involvement As principal diagnosis.
I01 Rheumatic fever with heart involvement As principal diagnosis.
I02 Rheumatic chorea As principal diagnosis.
I05 Rheumatic mitral valve diseases As principal diagnosis.
I06 Rheumatic aortic valve diseases As principal diagnosis.
I07 Rheumatic tricuspid valve diseases As principal diagnosis.
I08 Multiple valve diseases As principal diagnosis.
I09 Other rheumatic heart diseases As principal diagnosis.
Acute
Pneumonia (not vaccine-preventable) J15.3 Pneumonia due to streptococcus, group B

In any diagnosis.

Exclude people under 2 months.

J15.4 Pneumonia due to other streptococci

In any diagnosis.

Exclude people under 2 months.

J15.7 Pneumonia due to Mycophasma pneumoniae

In any diagnosis.

Exclude people under 2 months.

J16.0 Chlamydial pneumonia

In any diagnosis.

Exclude people under 2 months.

Urinary tract infections, including pyelonephritis N10 Acute tublo-interstitial nephnitis As principal diagnosis.
N11 Chronic tublo-interstitial nephritis As principal diagnosis.
N12 Tubolo-interstitial nephritis, not specified as acute or chronic As principal diagnosis.
N13.6 Pyonephrosis As principal diagnosis.
N15.1 Renal and perinephric abscess As principal diagnosis.
N15.9 Renal tubule-interstitial disease, unspecified As principal diagnosis.
N28.9 Disorders of kidney and ureter, unspecified As principal diagnosis.
N39.0 Urinary tract infection, site not specified As principal diagnosis.
N39.9 Disorder or urinary system, unspecified As principal diagnosis.
Perforated/bleeding ulcer K25.0 Gastric ulcer, acute with haemorrhage As principal diagnosis.
K25.1 Gastric ulcer, acute with perforation As principal diagnosis.
K25.2 Gastric ulcer, acute with both haemorrhage and perforation As principal diagnosis.
K25.4 Gastric ulcer, chronic or unspecified with haemorrhage As principal diagnosis.
K25.5 Gastric ulcer, chronic or unspecified with perforation As principal diagnosis.
K25.6 Gastric ulcer, chronic or unspecified with both haemorrhage and perforation As principal diagnosis.
K26.0 Duodenal ulcer, acute with haemorrhage As principal diagnosis.
K26.1 Duodenal ulcer, acute with perforation As principal diagnosis.
K26.2 Duodenal ulcer, acute with both haemorrhage and perforation As principal diagnosis.
K26.4 Duodenal ulcer, chronic or unspecified with haemorrhage As principal diagnosis.
K26.5 Duodenal ulcer, chronic or unspecified with perforation As principal diagnosis.
K26.6 Duodenal ulcer, chronic or unspecified with both haemorrhage and perforation As principal diagnosis.
K27.0 Peptic ulcer, site unspecified, acute with haemorrhage As principal diagnosis.
K27.1 Peptic ulcer, site unspecified, acute with perforation As principal diagnosis.
K27.2 Peptic ulcer, site unspecified, acute with both haemorrhage and perforation As principal diagnosis.
K27.4 Peptic ulcer, site unspecified, chronic or unspecified with both haemorrhage and perforation As principal diagnosis.
K27.5 Peptic ulcer, site unspecified, chronic or unspecified with both haemorrhage and perforation As principal diagnosis.
K27.6 Peptic ulcer, site unspecified, chronic or unspecified with both haemorrhage and perforation As principal diagnosis.
K28.0 Gastrojejunal ulcer, acute with haemorrhage As principal diagnosis.
K28.1 Gastrojejunal ulcer, acute with perforation As principal diagnosis.
K28.2 Gastrojejunal ulcer, acute with both haemorrhage and perforation As principal diagnosis.
K28.4 Gastrojejunal ulcer, chronic or unspecified with haemorrhage As principal diagnosis.
K28.5 Gastrojejunal ulcer, chronic or unspecified with perforation As principal diagnosis.
K28.6 Gastrojejunal ulcer, chronic or unspecified with both haemorrhage and perforation As principal diagnosis.
Cellulitis L02 Cutaneous abscess, furuncle and carbuncle

As principal diagnosis.

Exclude cases with any procedure except those in blocks 1820 to 2016, or if procedure is 30216-00, 30216-01, 30216-02, 30676-00, 30223-01, 30223-02, 30064-00, 90660-00, 90661-00, and this is the only listed procedure.

L03 Cellulitis

As principal diagnosis.

Exclude cases with any procedure except those in blocks 1820 to 2016, or if procedure is 30216-00, 30216-01, 30216-02, 30676-00, 30223-01, 30223-02, 30064-00, 90660-00, 90661-00, and this is the only listed procedure.

L04 Acute Lymphadenitis

As principal diagnosis.

Exclude cases with any procedure except those in blocks 1820 to 2016, or if procedure is 30216-00, 30216-01, 30216-02, 30676-00, 30223-01, 30223-02, 30064-00, 90660-00, 90661-00, and this is the only listed procedure.

L08 Other local infections of skin and subcutaneous tissue

As principal diagnosis.

Exclude cases with any procedure except those in blocks 1820 to 2016, or if procedure is 30216-00, 30216-01, 30216-02, 30676-00, 30223-01, 30223-02, 30064-00, 90660-00, 90661-00, and this is the only listed procedure.

L88 Pyoderma gangrenosum

As principal diagnosis.

Exclude cases with any procedure except those in blocks 1820 to 2016, or if procedure is 30216-00, 30216-01, 30216-02, 30676-00, 30223-01, 30223-02, 30064-00, 90660-00, 90661-00, and this is the only listed procedure.

L98.0 Pyogenic granuloma

As principal diagnosis.

Exclude cases with any procedure except those in blocks 1820 to 2016, or if procedure is 30216-00, 30216-01, 30216-02, 30676-00, 30223-01, 30223-02, 30064-00, 90660-00, 90661-00, and this is the only listed procedure.

L98.3 Eosinphilic cellulitis [Wells]

As principal diagnosis.

Exclude cases with any procedure except those in blocks 1820 to 2016, or if procedure is 30216-00, 30216-01, 30216-02, 30676-00, 30223-01, 30223-02, 30064-00, 90660-00, 90661-00, and this is the only listed procedure.

Pelvic inflammatory disease N70 Salpingitis and oophoritis As principal diagnosis.
N73 Other female pelvic inflammatory diseases As principal diagnosis.
N74 Other female pelvic inflammatory disorders in diseases classified elsewhere As principal diagnosis.
Ear, nose and throat infections H66 Suppurative and unspecified otitis media As principal diagnosis.
J02 Acute pharyngitis As principal diagnosis.
J03 Acute tonsillitis As principal diagnosis.
J06 Acute upper respiratory infections of multiple and unspecified sites As principal diagnosis.
J31.2 Chronic pharyngitis As principal diagnosis.
Dental conditions K02 Dental caries As principal diagnosis.
K03 Other diseases of hard tissues of teeth As principal diagnosis.
K04 Diseases of pulp and periapical tissues As principal diagnosis.
K05 Gingivitis and periodontal diseases As principal diagnosis.
K06 Other disorders of gingiva and edentulous alveolar ridge As principal diagnosis.
K08 Other disorders of teeth and supporting structures As principal diagnosis.
K09.8 Other cysts of oral region, not elsewhere classified As principal diagnosis.
K09.9 Cyst of oral region, unspecified As principal diagnosis.
K12 Stomatitis and related lesions As principal diagnosis.
K13 Other diseases of lip and oral mucosa As principal diagnosis.
K14.0 Glossitis As principal diagnosis.
Convulsions and epilepsy G40 Epilepsy As principal diagnosis.
G41 Status epilepticus As principal diagnosis.
R56 Convulsions, not elsewhere classified As principal diagnosis.
Eclampsia O15 Eclampsia As principal diagnosis.
Gangrene R02 Gangrene, not elsewhere classified In any diagnosis.
I70.24 Atherosclerosis of arteries of extremities with gangrene As principal diagnosis.
E09.52 Impaired glucose regulation with peripheral angiopathy, with gangrene As principal diagnosis.

Rates directly age-standardised to the 2001 Australian population.

Analysis by state and territory, remoteness and SEIFA Index of Relative Socioeconomic Disadvantage (IRSD) is based on usual residence of person.

Presented as a number per 100,000 population.

Computation:Help on this term100,000 x (Numerator ÷ Denominator)
Numerator:Help on this term

Number of potentially preventable hospitalisations, divided into three groups and total:

  • vaccine-preventable conditions (e.g. tetanus, measles, mumps, rubella).
  • acute conditions (e.g. ear, nose and throat infections, perforated/bleeding ulcer, pelvic inflammatory disease).
  • chronic conditions (e.g. diabetes complications, asthma, angina, hypertension, congestive heart failure and chronic obstructive pulmonary disease).
  • all potentially preventable hospitalisations.
Numerator data elements:Help on this term
Data Element / Data SetEpisode of admitted patient care—admission date, DDMMYYYY
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2012-13
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetEpisode of care—principal diagnosis, code (ICD-10-AM 7th edn) ANN{.N[N]}
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2012-13
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetEpisode of care—additional diagnosis, code (ICD-10-AM 7th edn) ANN{.N[N]}
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2012-13
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetEpisode of admitted patient care—condition onset flag, code N
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2012-13
Guide for use
Data source type: Administrative by-product data
Denominator:Help on this termTotal population
Denominator data elements:Help on this term
Data Element / Data SetData Element
Person—estimated resident population of Australia
Data Source
ABS Estimated resident population (total population)
Guide for use
Data source type: Census-based plus administrative by-product data
Data Element / Data SetData Element
Person—estimated resident population of Australia
Data Source
ABS Indigenous experimental estimates and projections (2001 Census-based)
Guide for use
Data source type: Census-based plus administrative by-product data
Data Element / Data Set
Disaggregation:Help on this term

2007–08, 2008–09, 2009–10, 2010–11, 2011–12 (resupplied for revised specification) and 2012–13—Nationally (by three groups and total) by:

  • Socio-Economic Indexes for Areas (SEIFA) Index of Relative Socioeconomic Disadvantage (IRSD) deciles (2006 SEIFA IRSD deciles for 2010-11 and previous years data, 2011 SEIFA IRSD deciles for 2011-12 and subsequent years data).
  • Sex.

2012–13—Nationally (by three groups and total), by:

  • Indigenous status by remoteness (Australian Statistical Geography Standard (ASGS) Remoteness Structure).

2007–08, 2008–09, 2009–10, 2010–11, 2011–12 (resupplied for revised specification) and 2012–13—State and territory (by three groups and total), by:

  • remoteness (ASGC Remoteness Structure for 2011-12 and previous years data, ASGS Remoteness Structure for 2012-13 data).
  • SEIFA IRSD quintiles (2006 SEIFA IRSD quintiles for 2010-11 and previous years data, 2011 SEIFA IRSD quintiles for 2011-12 and subsequent years data).

2007–08, 2008–09, 2009–10, 2010–11, 2011–12 (resupplied for revised specification and updated Indigenous ERP), 2012–13—State and territory (by three groups and total), by:

  • Indigenous status.

Some disaggregation may result in numbers too small for publication. National disaggregation by Indigenous status will be based on data only from jurisdictions for which the quality of Indigenous identification is considered acceptable.

Disaggregation data elements:Help on this term
Data Element / Data SetPerson—area of usual residence, statistical area level 2 (SA2) code (ASGS 2011) N(9)
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2012-13
Guide for use
Data source type: Administrative by-product data
Used for disaggregation by state/territory, remoteness and SEIFA IRSD
Data Element / Data SetPerson—Indigenous status, code N
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2012-13
Guide for use
Data source type: Administrative by-product data
Comments:Help on this term

Most recent data available for 2015 National Healthcare Agreement (NHA) performance reporting: 2012–13.

The scope of the National Hospital Morbidity Database (NHMD) is episodes of care for admitted patients in essentially all hospitals in Australia, including public and private acute and psychiatric hospitals, free-standing day hospital facilities, alcohol and drug treatment hospitals and dental hospitals.

For 2010-11 and previous years data, the SEIFA IRSD quintiles and deciles used are 2006 SEIFA quintiles and deciles derived using the Australian Standard Geography Classification (ASGC) geographical unit of Statistical Local Area (SLA). For 2011-12 data, the SEIFA IRSD quintile and decile data are produced using the 2011 SEIFA IRSD quintiles and deciles derived using the ASGC geographical unit of SLA.  For 2012-13 data, the SEIFA IRSD quintiles and deciles used are 2011 SEIFA IRSD quintiles and deciles derived using the Australian Statistical Geography Standard geographical unit of Statistical Area 2.

Representational attributes

Representation class:Help on this termRate
Data type:Help on this termReal
Unit of measure:Help on this termEpisode
Format:Help on this termNN[NN].N

Indicator conceptual framework

Framework and dimensions:Help on this termAccessibility

Effectiveness

Safety

Data source attributes

Data sources:Help on this term
Data SourceNational Hospital Morbidity Database (NHMD)
Frequency
Annual
Quality statement
Data quality statement: National Hospital Morbidity Database 2013–14
Data custodian
Australian Institute of Health and Welfare

Data SourceABS Estimated resident population (total population)
Frequency
Quarterly
Quality statement
ABS Estimated resident population (total population), QS
Data custodian
Australian Bureau of Statistics

Data SourceABS Indigenous experimental estimates and projections (2001 Census-based)
Frequency
Periodic
Quality statement
ABS Indigenous experimental estimates and projections, QS
Data custodian
Australian Bureau of Statistics

Accountability attributes

Organisation responsible for providing data:Help on this termAustralian Institute of Health and Welfare
Benchmark:Help on this term

National Healthcare Agreement: PB f-By 2014-15, improve the provision of primary care and reduce the proportion of potentially preventable hospital admissions by 7.6 per cent over the 2006-07 baseline to 8.5 per cent of total hospital admissions, 2015

Further data development / collection required:Help on this termSpecification: Minor work required, the measure needs minor work to meet the intention of the indicator.

Relational attributes

Related metadata references:Help on this term

See also National Healthcare Agreement: PB f-By 2014-15, improve the provision of primary care and reduce the proportion of potentially preventable hospital admissions by 7.6 per cent over the 2006-07 baseline to 8.5 per cent of total hospital admissions, 2015 Health, Superseded 08/07/2016

See also National Healthcare Agreement: PI 16-Potentially avoidable deaths, 2015 Health, Superseded 08/07/2016

Supersedes National Healthcare Agreement: PI 18-Selected potentially preventable hospitalisations, 2014 Health, Superseded 14/01/2015

Has been superseded by National Healthcare Agreement: PI 18–Selected potentially preventable hospitalisations, 2016 Health, Standard 08/07/2016

See also National Healthcare Agreement: PI 23-Unplanned hospital readmission rates, 2015 Health, Superseded 08/07/2016

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