National Healthcare Agreement: PI 43-Unplanned/unexpected readmissions within 28 days of selected surgical admissions, 2011

Identifying and definitional attributes
Metadata item type:	Indicator
Indicator type:	Progress measure
Short name:	PI 43-Unplanned/unexpected readmissions within 28 days of selected surgical admissions, 2011
METEOR identifier:	421607
Registration status:	Health, Superseded 31/10/2011
Description:	Unplanned and unexpected hospital readmissions within 28 days for selected surgical procedures.
Indicator set:	National Healthcare Agreement (2011) Health, Superseded 31/10/2011
Outcome area:	Hospital and Related Care National Health Performance Authority (retired), Retired 01/07/2016 Health, Standard 07/07/2010
Quality statement:	National Healthcare Agreement: PI 43: Unplanned/unexpected readmissions within 28 days of selected surgical admissions, 2011 QS Health, Superseded 04/12/2012

Collection and usage attributes

Computation description:

Unplanned/unexpected readmissions are those readmissions where the principal diagnosis indicates an adverse event. These include ICD-10AM codes: T80-88, T98.3, E89, G97, H59, H95, I97, J95, K91, M96 or N99.

Principal diagnoses codes

A principal diagnosis for the readmission has one of the following ICD-10-AM (6th Ed) codes: T80–88, T98.3, E89, G97, H59, H95, I97, J95, K91, M96 or N99.

T80 Complications following infusion, transfusion and therapeutic injection

T81 Complications of procedures, not elsewhere classified

T82 Complications of cardiac and vascular prosthetic devises, implants and grafts

T83 Complications of genitourinary prosthetic devices, implants and grafts

T84 Complications of internal orthopaedic prosthetic devices, implants and grafts

T85 Complications of other internal prosthetic devices, implants and grafts

T86 Failure and rejection of transplanted organs and tissues

T87 Complications peculiar to reattachment and amputation

T88 Other complications of surgical and medical care, not elsewhere classified

T98.3 Sequelae of complications of surgical and medical care, not elsewhere classified

E89 Postprocedural endocrine and metabolic disorders, not elsewhere classified

G97 Postprocedural disorders of nervous system, not elsewhere classified

H59 Postprocedural disorders of eye and adnexa, not elsewhere classified

H95 Postprocedural disorders of ear and mastoid process, not elsewhere classified

I97 Postprocedural disorders of circulatory system, not elsewhere classified

J95 Postprocedural respiratory disorders, not elsewhere classified

K91 Postprocedural disorders of digestive system, not elsewhere classified

M96 Postprocedural musculoskeletal disorders, not elsewhere classified

N99 Postprocedural disorders of genitourinary system, not elsewhere classified

Procedure codes

Number of separations in which one of the following surgical procedures was undertaken: knee replacement; hip replacement; tonsillectomy and adenoidectomy; hysterectomy; prostatectomy; cataract surgery; appendicectomy.

The following is a list of the specific ACHI (6th Ed) procedure codes which are included in the specifications for each of the selected surgical procedures.

Procedure	Procedure Codes	Description
Knee replacement	49518-00	Total arthroplasty of knee, unilateral
	49519-00	Total arthroplasty of knee, bilateral
	49521-02	Total arthroplasty of knee with bone graft to tibia, unilateral
Hip replacement	49318-00	Total arthroplasty of hip, unilateral
	49319-00	Total arthroplasty of hip, bilateral
Tonsillectomy and adenoidectomy	41789-00	Tonsillectomy without adenoidectomy
	41789-01	Tonsillectomy with adenoidectomy
	41801-00	Adenoidectomy without tonsillectomy
Hysterectomy	35653-01	Total abdominal hysterectomy
	35653-04	Total abdominal hysterectomy with removal of adnexa
	35661-00	Abdominal hysterectomy with extensive retroperitoneal dissection
	35670-00	Abdominal hysterectomy with radical excision of pelvic lymph nodes
	35756-00	Laparoscopically assisted vaginal hysterectomy proceeding to abdominal hysterectomy
	35756-03	Laparoscopically assisted vaginal hysterectomy proceeding to abdominal hysterectomy with removal of adnexa
	90448-01	Total laparoscopic abdominal hysterectomy
	90448-02	Total laparoscopic abdominal hysterectomy with removal of adnexa
	35657-00	Vaginal hysterectomy
	35673-02	Vaginal hysterectomy with removal of adnexa
	35667-00	Radical abdominal hysterectomy
	35664-00	Radical abdominal hysterectomy with radical excision of pelvic lymph nodes
	35664-01	Radical vaginal hysterectomy with radical excision of pelvic lymph nodes
	35667-01	Radical vaginal hysterectomy
	90443-00	Other excision of uterus

Prostatectomy	37207-00	Endoscopic laser ablation of prostate (includes TULIP)
	37201-00	Transurethral needle ablation of prostate
	37203-00	Transurethral resection of prostate
	37203-02	Transurethral electrical vaporisation of prostate
	37203-04	Microwave thermotherapy of prostate
	37203-05	High intensity focussed ultrasound (transrectal) of prostate
	37207-01	Endoscopic laser excision of prostate
	37200-03	Suprapubic prostatectomy
	37200-04	Retropubic prostatectomy
	37224-00	Endoscopic destruction of prostatic lesion
	37224-01	Endoscopic resection of prostatic lesion
	90407-00	Excision of other lesion of prostate
	37203-03	Cryoablation of prostate
Cataract surgery	42698-00	Intracapsular extraction of crystalline lens
	42702-00	Intracapsular extraction of crystalline lens with insertion of foldable artificial lens
	42702-01	Intracapsular extraction of crystalline lens with insertion of other artificial lens
	42698-01	Extracapsular extraction of crystalline lens by simple aspiration (and irrigation) technique
	42702-02	Extracapsular extraction of crystalline lens by simple aspiration (and irrigation) technique with insertion of foldable artificial lens
	42702-03	Extracapsular extraction of crystalline lens by simple aspiration (and irrigation) technique with insertion of other artificial lens
	42698-02	Extracapsular extraction of crystalline lens by phacoemulsification and aspiration of cataract
	42702-04	Extracapsular extraction of crystalline lens by phacoemulsification and aspiration of cataract with insertion of foldable artificial lens
	42702-05	Extracapsular extraction of crystalline lens by phacoemulsification and aspiration of cataract with insertion of other artificial lens
	42698-03	Extracapsular crystalline lens extraction by mechanical phacofragmentation and aspiration of cataract
	42702-06	Extracapsular crystalline lens extraction by mechanical phacofragmentation and aspiration of cataract with insertion of foldable artificial lens
	42702-07	Extracapsular crystalline lens extraction by mechanical phacofragmentation and aspiration of cataract with insertion of other artificial lens
	42698-04	Other extracapsular extraction of crystalline lens
	42702-08	Other extracapsular extraction of crystalline lens with insertion of foldable artificial lens
	42702-09	Other extracapsular extraction of crystalline lens with insertion of other artificial lens
	42731-01	Extraction of crystalline lens by posterior chamber sclerotomy with removal of vitreous
	42698-05	Other extraction of crystalline lens
	42702-10	Other extraction of crystalline lens with insertion of foldable artificial lens
	42702-11	Other extraction of crystalline lens with insertion of other artificial lens
Appendicectomy	30571-00	Appendicectomy
	30572-00	Laparoscopic appendicectomy

Limited to public hospitals.

Denominator limited to separations with a separation date between 1 July and 19 May in the reference year.

Denominator excludes separations where the patient died in hospital.

Analysis by state and territory is based on location of service.

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

Presented per 1,000 separations.

Computation:

1,000 x (Numerator ÷ Denominator)

Calculated separately for each of the specified procedures

Numerator:

Number of separations for public hospitals which meet all of the following criteria:

The separation is a readmission to the same hospital following a separation in which one of the following procedures was performed: knee replacement; hip replacement; tonsillectomy and adenoidectomy; hysterectomy; prostatectomy; cataract surgery; appendicectomy (see procedure codes in computation description field)
The readmission occurs within 28 days of the previous date of separation
A principal diagnosis for the readmission has one of the following ICD10-AM codes: T80–88, T98.3, E89, G97, H59, H95, I97, J95, K91, M96 or N99

Numerator data elements:

Data Element / Data SetEpisode of admitted patient care—admission date, DDMMYYYY
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2008-09
Guide for use
Data source type: Administrative by-product data

Data Element / Data SetEstablishment—sector, code N
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2008-09
Guide for use
Data source type: Administrative by-product data

Data Element / Data SetEpisode of admitted patient care—separation date, DDMMYYYY
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2008-09
Guide for use
Data source type: Administrative by-product data

Data Element / Data SetPerson—person identifier, XXXXXX[X(14)]
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2008-09
Guide for use
Data source type: Administrative by-product data

Data Element / Data SetEpisode of care—principal diagnosis, code (ICD-10-AM 6th edn) ANN{.N[N]}
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2008-09
Guide for use
Data source type: Administrative by-product data

Data Element / Data SetEpisode of admitted patient care—procedure, code (ACHI 6th edn) NNNNN-NN
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2008-09
Guide for use
Data source type: Administrative by-product data

Denominator:

Denominator data elements:

Disaggregation:

2008–09—Nationally, by specified procedures by SEIFA Index of Relative Socioeconomic Disadvantage (IRSD) deciles

2008–09—State and territory, by specified procedures (and total), by:

peer group
Indigenous status
remoteness
SEIFA IRSD quintiles

Disaggregations within individual jurisdictions are subject to data quality considerations. Some disaggregations 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:

Data Element / Data SetData Element
Hospital peer group
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2008-09
Guide for use
Data source type: Administrative by-product data

Data Element / Data SetEstablishment—Australian state/territory identifier, code N
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2008-09
Guide for use
Data source type: Administrative by-product data

Data Element / Data SetPerson—Indigenous status, code N
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2008-09
Guide for use
Data source type: Administrative by-product data

Data Element / Data SetPerson—area of usual residence, geographical location code (ASGC 2007) NNNNN
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2008-09
Guide for use
Data source type: Administrative by-product data
Used for disaggregation by remoteness and SEIFA IRSD

Comments:

Most recent data available for 2011 CRC report: 2008–09

Representational attributes

Representation class:

Rate

Data type:

Real

Unit of measure:

Person

Format:

N[N].N

Indicator conceptual framework

Framework and dimensions:

Effectiveness

Safety

Accessibility

Data source attributes

Data sources:

Data SourceNational Hospital Morbidity Database (NHMD)
Frequency
Annual
Data custodian

Australian Institute of Health and Welfare

Accountability attributes

Reporting requirements:

National Healthcare Agreement

Organisation responsible for providing data:

Australian Institute of Health and Welfare

Further data development / collection required:

Specification: Interim

Source and reference attributes

Relational attributes

Related metadata references: