National Healthcare Agreement: PI 23–Unplanned hospital readmission rates, 2020

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termProgress measure
Short name:Help on this termPI 23–Unplanned hospital readmission rates, 2020
METEOR identifier:Help on this term716786
Registration status:Help on this term
Description:Help on this term

Unplanned and unexpected hospital readmissions to the same public hospitals within 28 days for selected surgical procedures.

Indicator set:Help on this termNational Healthcare Agreement (2020)
Health, Standard 13/03/2020
Outcome area:Help on this termHospital and Related Care
National Health Performance Authority (retired), Retired 01/07/2016
Health, Standard 07/07/2010

Collection and usage attributes

Computation description:Help on this term

Unplanned/unexpected hospital readmissions are those readmissions where the principal diagnosis indicates an adverse event.

Principal diagnoses codes

A principal diagnosis for the readmission has one of the following ICD-10-AM (10th edn.) codes: T80–88, 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 devices, 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

E89 Intraoperative and postprocedural disorders of endocrine and metabolic system, not elsewhere classified

G97 Intraoperative and postprocedural disorders of nervous system, not elsewhere classified

H59 Intraoperative and postprocedural disorders of eye and adnexa, not elsewhere classified

H95 Intraoperative and postprocedural disorders of ear and mastoid process, not elsewhere classified

I97 Intraoperative and postprocedural disorders of circulatory system, not elsewhere classified

J95 Intraoperative and postprocedural disorders of respiratory system, not elsewhere classified

K91 Intraoperative and postprocedural disorders of digestive system, not elsewhere classified

M96 Intraoperative and postprocedural disorders of musculoskeletal system, not elsewhere classified

N99 Intraoperative and postprocedural disorders of genitourinary system, not elsewhere classified

Procedure codes

Number of separations in which 1 of the following surgical procedures was undertaken: knee replacement; hip replacement; tonsillectomy and adenoidectomy; hysterectomy; prostatectomy; cataract surgery; or appendicectomy.

The following is a list of the specific Australian Classification of Health Interventions (10th edn) 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

 

49521–00

Total arthroplasty of knee with bone graft to femur, unilateral

 

49524–00

Total arthroplasty of knee with bone graft to femur and 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

 41789–01Tonsillectomy with adenoidectomy
 41801–00Adenoidectomy without tonsillectomy
Hysterectomy35653–01Total abdominal hysterectomy
 35653–04Total abdominal hysterectomy with removal of adnexa
 35661–00Abdominal hysterectomy with extensive retroperitoneal dissection
 35670–00Abdominal hysterectomy with radical excision of pelvic lymph nodes
 90448–01Total laparoscopic abdominal hysterectomy
 90448–02Total laparoscopic abdominal hysterectomy with removal of adnexa
 35657–00Vaginal hysterectomy
 35673–02Vaginal hysterectomy with removal of adnexa
 35667–00Radical abdominal hysterectomy
 35664–00Radical abdominal hysterectomy with radical excision of pelvic lymph nodes
 35664–01Radical vaginal hysterectomy with radical excision of pelvic lymph nodes
 35667–01Radical vaginal hysterectomy
 90443–00Other excision of uterus
Prostatectomy37200–03Suprapubic prostatectomy
 37200–04Retropubic prostatectomy
 37224–00Endoscopic destruction procedures on prostate
 37224–03Endoscopic resection of prostate
 90407–00Excision of other lesion of prostate
 90408–00Destruction procedures on prostate
 90408–02Other closed destruction procedures on prostate
 37209–01Laparoscopic radical prostatectomy
 37210–01Laparoscopic radical prostatectomy with bladder neck reconstruction
 37211–01Laparoscopic radical prostatectomy with bladder neck reconstruction and pelvic lymphadenectomy
 37209–00Radical prostatectomy
 37210–00Radical prostatectomy with bladder neck reconstruction
 37211–00Radical prostatectomy with bladder neck reconstruction and pelvic lymphadenectomy
 37200–05Other open prostatectomy
 37203–06Other closed prostatectomy
Cataract surgery42698–05Other extraction of crystalline lens
 42698–06Intracapsular extraction of crystalline lens
 42698–07Phacoemulsification of crystalline lens
 42698–08Other extracapsular extraction of crystalline lens
 42731–01Extraction of crystalline lens with removal of vitreous
Appendicectomy30571–00Appendicectomy
 30572–00Laparoscopic 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 the service.

Analysis by remoteness and Socio-Economic Indexes for Areas (SEIFA) Index of Relative Socio-Economic Disadvantage (IRSD) is based on usual residence of the person.

Presented per 1,000 separations.

Computation:Help on this term

1,000 x (Numerator ÷ Denominator)

Calculated separately for each of the specified procedures

Numerator:Help on this term

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; or appendicectomy (see procedure codes in Computation description)
  • the readmission occurs within 28 days of the previous date of separation
  • a principal diagnosis for the readmission has 1 of the following ICD-10-AM codes: T80–88, E89, G97, H59, H95, I97, J95, K91, M96 or N99.
Numerator data elements:Help on this term
Data Element / Data Set

Episode of admitted patient care—admission date, DDMMYYYY

Data Source

National Hospital Morbidity Database (NHMD)

NMDS / DSS

Admitted patient care NMDS 2017-18

Guide for use

Data source type: Administrative by-product data

Data Element / Data Set

Establishment—organisation identifier (state/territory), NNNNN

Data Source

National Hospital Morbidity Database (NHMD)

NMDS / DSS

Admitted patient care NMDS 2017-18

Guide for use

Data source type: Administrative by-product data

Data Element / Data Set

Establishment—sector, code N

Data Source

National Hospital Morbidity Database (NHMD)

NMDS / DSS

Admitted patient care NMDS 2017-18

Guide for use

Data source type: Administrative by-product data

Data Element / Data Set

Episode of admitted patient care—separation date, DDMMYYYY

Data Source

National Hospital Morbidity Database (NHMD)

NMDS / DSS

Admitted patient care NMDS 2017-18

Guide for use

Data source type: Administrative by-product data

Data Element / Data Set

Person—person identifier, XXXXXX[X(14)]

Data Source

National Hospital Morbidity Database (NHMD)

NMDS / DSS

Admitted patient care NMDS 2017-18

Guide for use

Data source type: Administrative by-product data

Data Element / Data Set

Episode of care—principal diagnosis, code (ICD-10-AM 10th edn) ANN{.N[N]}

Data Source

National Hospital Morbidity Database (NHMD)

NMDS / DSS

Admitted patient care NMDS 2017-18

Guide for use

Data source type: Administrative by-product data

Denominator:Help on this term

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.

Denominator data elements:Help on this term
Data Element / Data Set

Episode of admitted patient care—admission date, DDMMYYYY

Data Source

National Hospital Morbidity Database (NHMD)

NMDS / DSS

Admitted patient care NMDS 2017-18

Guide for use

Data source type: Administrative by-product data

Data Element / Data Set

Establishment—organisation identifier (state/territory), NNNNN

Data Source

National Hospital Morbidity Database (NHMD)

NMDS / DSS

Admitted patient care NMDS 2017-18

Guide for use

Data source type: Administrative by-product data

Data Element / Data Set

Establishment—sector, code N

Data Source

National Hospital Morbidity Database (NHMD)

NMDS / DSS

Admitted patient care NMDS 2017-18

Guide for use

Data source type: Administrative by-product data

Data Element / Data Set

Episode of admitted patient care—separation date, DDMMYYYY

Data Source

National Hospital Morbidity Database (NHMD)

NMDS / DSS

Admitted patient care NMDS 2017-18

Guide for use

Data source type: Administrative by-product data

Data Element / Data Set

Episode of admitted patient care—procedure, code (ACHI 10th edn) NNNNN-NN

Data Source

National Hospital Morbidity Database (NHMD)

NMDS / DSS

Admitted patient care NMDS 2017-18

Guide for use

Data source type: Administrative by-product data

Disaggregation:Help on this term

2017–18—Nationally, by specified procedures, by:

  • peer group
  • Indigenous status
  • remoteness (Australian Statistical Geography Standard (ASGS) 2016 Remoteness Structure)
  • 2016 SEIFA IRSD quintiles

2017–18—State and territory, by specified procedures.

Disaggregation by peer group used the peer group classification as described in the AIHW publication Australian hospital peer groups.

Some disaggregations may result in numbers too small for publication.

Disaggregation data elements:Help on this term
Data Element / Data Set

Establishment—Australian state/territory identifier, code N

Data Source

National Hospital Morbidity Database (NHMD)

NMDS / DSS

Admitted patient care NMDS 2017-18

Guide for use

Data source type: Administrative by-product data

Data Element / Data Set

Establishment—organisation identifier (state/territory), NNNNN

Data Source

National Hospital Morbidity Database (NHMD)

NMDS / DSS

Admitted patient care NMDS 2017-18

Guide for use

Data source type: Administrative by-product data

Used to derive hospital peer group

Data Element / Data Set

Person—Indigenous status, code N

Data Source

National Hospital Morbidity Database (NHMD)

NMDS / DSS

Admitted patient care NMDS 2017-18

Guide for use

Data source type: Administrative by-product data

Data Element / Data Set

Episode of admitted patient care—procedure, code (ACHI 10th edn) NNNNN-NN

Data Source

National Hospital Morbidity Database (NHMD)

NMDS / DSS

Admitted patient care NMDS 2017-18

Guide for use

Data source type: Administrative by-product data

Data Element / Data Set

Person—area of usual residence, statistical area level 2 (SA2) code (ASGS 2016) N(9)

Data Source

National Hospital Morbidity Database (NHMD)

NMDS / DSS

Admitted patient care NMDS 2017-18

Guide for use

Data source type: Administrative by-product data
Used for disaggregation by remoteness and SEIFA IRSD

Comments:Help on this term

Most recent data available for 2020 National Healthcare Agreement performance reporting: 2017–18.

The scope of the National Hospital Morbidity Database 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 2017–18 data, the 2016 SEIFA IRSD quintile and decile data will be produced using the Australian Statistical Geography Standard 2016 geographical unit of Statistical Area Level 2.

Note that for the 2016 and previous reports, disaggregations by public hospital peer group for this indicator were calculated using the peer group classification method as reported in Australian hospital statistics 2010–11.

Representational attributes

Representation class:Help on this termRate
Data type:Help on this termReal
Unit of measure:Help on this termPerson
Format:Help on this term

N[NN].N

Indicator conceptual framework

Framework and dimensions:Help on this termEffectiveness

Safety

Accessibility

Data source attributes

Data sources:Help on this term
Data Source

National Hospital Morbidity Database (NHMD)

Frequency

Annual

Data custodian

Australian Institute of Health and Welfare

Accountability attributes

Reporting requirements:Help on this term

National Healthcare Agreement

Organisation responsible for providing data:Help on this term

Australian Institute of Health and Welfare

Further data development / collection required:Help on this term

Specification: Substantial work required, the measure requires significant work to be undertaken.

Source and reference attributes

Reference documents:Help on this term

AIHW (Australian Institute of Health and Welfare) 2012. Australian hospital statistics 2010–11. Health services series no. 43. Cat. no. HSE 117. Canberra: AIHW.

AIHW 2015. Australian hospital peer groups. Health services series no. 66. Cat. no. HSE 170. Canberra: AIHW.

Relational attributes

Related metadata references:Help on this term
See also Australian Health Performance Framework: PI 2.1.4–Selected potentially preventable hospitalisations, 2019
See also Australian Health Performance Framework: PI 2.1.4–Selected potentially preventable hospitalisations, 2020
See also Australian Health Performance Framework: PI 2.1.6–Potentially avoidable deaths, 2019
See also Australian Health Performance Framework: PI 2.1.6–Potentially avoidable deaths, 2020
See also Australian Health Performance Framework: PI 2.2.1–Adverse events treated in hospitals, 2019
See also Australian Health Performance Framework: PI 2.2.1–Adverse events treated in hospitals, 2020
See also Australian Health Performance Framework: PI 2.4.1–Unplanned hospital readmission rates, 2019
See also Australian Health Performance Framework: PI 2.4.1–Unplanned hospital readmission rates, 2020
See also National Healthcare Agreement: PI 16–Potentially avoidable deaths, 2020
See also National Healthcare Agreement: PI 18–Selected potentially preventable hospitalisations, 2020
See also National Healthcare Agreement: PI 22–Healthcare associated infections: Staphylococcus aureus bacteraemia, 2020
Supersedes National Healthcare Agreement: PI 23–Unplanned hospital readmission rates, 2019
  • Health, Superseded 13/03/2020
Has been superseded by National Healthcare Agreement: PI 23–Unplanned hospital readmission rates, 2021