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National Healthcare Agreement: P43-Unplanned/unexpected readmissions within 28 days of selected surgical admissions, 2010

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termReadmissions within 28 days of selected surgical admissions, 2010
METeOR identifier:Help on this term395081
Registration status:Help on this termHealth, Superseded 08/06/2011
Description:Help on this termUnplanned and unexpected hospital readmissions within 28 days for selected surgical procedures.
Indicator set:Help on this termNational Healthcare Agreement (2010) Health, Superseded 08/06/2011
Outcome area:Help on this termHospital and Related Care Health, Standard 07/07/2010
National Health Performance Authority (retired), Retired 01/07/2016
Quality statement:Help on this termNational Healthcare Agreement: P43-Unplanned/unexpected readmissions within 28 days of selected surgical admissions, 2010 QS Health, Superseded 08/06/2011

Collection and usage attributes

Computation description:Help on this term

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.

Presented per 1,000 separations.

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 (5th 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 & adenoidectomy; hysterectomy; prostatectomy; cataract surgery; appendicectomy.

The following is a list of the specific ACHI (5th 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 & adenoidectomy

41789-00

Tonsillectomy without adenoidectomy

 

41789-01

Tonsillectomy with adenoidectomy

 

41801-00

Adenoidectomy without tonsillectomy

Hysterectomy

35653-01

Total abdominal hysterectomy

 

35653-02

Abdominal hysterectomy with unilateral salpingo-oophorectomy

 

35653-03

Abdominal hysterectomy with bilateral salpingo-oophorectomy

 

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

 

35756-01

Laparoscopically assisted vaginal hysterectomy proceeding to abdominal hysterectomy with unilateral salpingo-oophorectomy

 

35756-02

Laparoscopically assisted vaginal hysterectomy proceeding to abdominal hysterectomy with bilateral salpingo-oophorectomy

 

35657-00

Vaginal hysterectomy

 

35673-00

Vaginal hysterectomy with unilateral salpingo-oophorectomy

 

35673-01

Vaginal hysterectomy with bilateral salpingo-oophorectomy

 

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

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 & adenoidectomy; hysterectomy; prostatectomy; cataract surgery; appendicectomy (see procedure codes in following table)
  • 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:Help on this term
Data Element / Data SetPerson—person identifier, XXXXXX[X(14)]
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetEstablishment—sector, code N
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetEpisode of admitted patient care—admission date, DDMMYYYY
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetEpisode of admitted patient care—separation date, DDMMYYYY
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetAdmitted patient care waiting list episode—scheduled admission date, DDMMYYYY
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetElective surgery waiting list episode—indicator procedure, code NN
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetEpisode of admitted patient care—procedure, code (ACHI 5th edn) NNNNN-NN
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetEpisode of care—principal diagnosis, code (ICD-10-AM 5th edn) ANN{.N[N]}
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Denominator:Help on this termNumber of separations in which one of the following surgical procedures was undertaken: knee replacement; hip replacement; tonsillectomy & adenoidectomy; hysterectomy; prostatectomy; cataract surgery; appendicectomy.
Denominator data elements:Help on this term
Data Element / Data SetEstablishment—sector, code N
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetEpisode of admitted patient care—procedure, code (ACHI 5th edn) NNNNN-NN
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetEpisode of admitted patient care—admission date, DDMMYYYY
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetEpisode of admitted patient care—separation date, DDMMYYYY
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Disaggregation data elements:Help on this term
Data Element / Data SetEstablishment—Australian state/territory identifier, code N
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetPerson—Indigenous status, code N
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Data Element / Data SetPerson—area of usual residence, geographical location code (ASGC 2006) NNNNN
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Used for disaggregation by remoteness area and SEIFA of residence
Data Element / Data SetData Element
Hospital peer group
Data Source
Admitted Patient Care National Minimum Data Set (APC NMDS)
NMDS / DSS
Admitted patient care NMDS 2007-08
Guide for use
Data source type: Administrative by-product data
Comments:Help on this term

Specified disaggregation: Nationally and by state/territory: Indigenous status, SEIFA of residence, remoteness area, hospital peer group.

Available disaggregation: Nationally and by state/territory: Indigenous status, SEIFA of residence, remoteness area, hospital peer group. 

Data for 2008-09 will be available in May 2010.

Most recent data available for 2010 CRC baseline report: 2007-08.

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 termN[N].N

Indicator conceptual framework

Framework and dimensions:Help on this termEffectiveness

Safety

Accessibility

Data source attributes

Data sources:Help on this term
Data SourceAdmitted Patient Care National Minimum Data Set (APC NMDS)
Frequency
Annual
Data custodian
Australian Institute of Health and Welfare

Accountability attributes

Reporting requirements:Help on this termNational Healthcare Agreement
Organisation responsible for providing data:Help on this termAustralian Institute of Health and Welfare
Further data development / collection required:Help on this term

Specification: Interim

Further development of data linkage-based approaches to construction of this indicator.

In future, linkage between consecutive years of data can allow analysis of 12 full months of data, and allow the 19 May cut-off date for the initial separation to be changed, if necessary. 

Further refinement of the procedures list and/or the included diagnoses on readmission, incorporating clinical advice, could be undertaken, if desired.

Consideration to be given to whether patient and establishment identifier information would be available for ‘within-hospital’ readmission rate calculation for private hospitals, and readmissions to a different hospital to the initial separation.

Possible development of data elements to identify unplanned/unexpected readmissions (for example, a data element to be used for each separation to indicate whether a readmission was planned).
Other issues caveats:Help on this termDisaggregations within individual jurisdictions will be limited by data quality considerations. Some disaggregations may result in numbers too small for publication.

Relational attributes

Related metadata references:Help on this term

See also National Healthcare Agreement: P20-Potentially avoidable deaths, 2010 Health, Superseded 08/06/2011

See also National Healthcare Agreement: P22-Selected potentially preventable hospitalisations, 2010 Health, Superseded 08/06/2011

See also National Healthcare Agreement: P38-Adverse drug events in hospitals, 2010 Health, Superseded 08/06/2011

See also National Healthcare Agreement: P39-Healthcare-associated Staphylococcus aureus (including MRSA) bacteraemia in acute care hospitals, 2010 Health, Superseded 08/06/2011

See also National Healthcare Agreement: P41-Falls resulting in patient harm in hospitals, 2010 Health, Superseded 08/06/2011

See also National Healthcare Agreement: P42-Intentional self-harm in hospitals, 2010 Health, Superseded 08/06/2011

Has been superseded by National Healthcare Agreement: PI 43-Unplanned/unexpected readmissions within 28 days of selected surgical admissions, 2011 Health, Superseded 31/10/2011

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