Coverage/Scope:

All public mental health service organisations acute psychiatric inpatient units.

• same-day separations
• separations where the length of stay is one night only and a procedure code for Electroconvulsive therapy (ECT) is recorded.

The following separations are excluded when calculating the denominator:

• same-day separations
• separations where the length of stay is one night only and a procedure code for Electroconvulsive therapy (ECT).
• statistical and change of care type separations
• separations that end in death
• separations that end by transfer to another acute or psychiatric hospital.

Methodology:

• Readmissions where the initial separation occurred within the reference period are in scope.
• Readmission is considered to have occurred if the person is admitted to any public acute psychiatric inpatient unit within the state/territory. Consequently, a state-wide unique patient identifier is required for accurate construction of this indicator.
• Readmissions where the person is separated and readmitted on the same day are included.
• For the purpose of this indicator, when a mental health service organisation has more than one unit of a particular admitted patient care program, those units should be combined.
• All acute admitted mental health service units are in scope for this indicator, including short-stay units and emergency acute mental health admitted units.
• The categorisation of the admitted patient unit is based on the principal purpose(s) of the admitted patient care program rather than the care type of individual consumers.
• The following ECT procedure codes are relevant for the excluded separations specified above:
  * ACHI 5th edition (2006–2008) use procedure codes 93340-02 and 93340-03.
  * ACHI 6th to 9th editions (2008 to 2015) use procedure codes 93341-00 to 93341-99.
  * ACHI 10th (2015 to current) edition use procedure codes 14224-0 to 14224-06.
  * ACHI 5th to 10th editions (2006 to current) Electroconvulsive therapy Block 1907 may be selected to capture all data regardless of code changes over time.

(Numerator ÷ Denominator) x 100

Number of in-scope overnight separations from the mental health service organisation’s acute admitted patient mental health care service unit(s) occurring within the reference period, that are followed by a readmission to the same or another acute psychiatric inpatient unit within 28 days.

Number of in-scope overnight separations from the mental health service organisation’s acute psychiatric inpatient unit(s) occurring within the reference period.

Service variables: target population.

Consumer attributes: diagnosis, age, Socio-Economic Indexes for Areas (SEIFA), remoteness, Indigenous status, involuntary status.

N[NN].N

Levels at which the indicator can be useful for benchmarking:

• service unit
• mental health service organisation
• regional group of services
• state/territory.

This indicator cannot be accurately constructed using the Admitted patient care NMDS. While the data set comprehensively provides a collection of separations from Australian public hospitals; its inability to uniquely identify a patient across episodes and across hospitals limits its capacity to count readmissions.

There is no proxy solution available. In order to report this indicator at a national level, states and territories are required to individually provide separate indicator data.

A reliable system of patient identifiers within the Admitted patient care NMDS is required to enable unique identification of individual consumers across multiple years, multiple admitted episodes and multiple hospitals.

Due to data limitations this indicator cannot differentiate between planned and unplanned readmissions.

This indicator does not track readmissions across state and territory boundaries or track movement between public and private hospitals.

Australian Institute of Health and Welfare on behalf of the National Mental Health Performance Subcommittee

National Mental Health Performance Subcommittee (NMHPSC) 2013. Key Performance Indicators for Australian Public Mental Health Services, 3rd edn. Canberra: NMHPSC.