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National Healthcare Agreement: PI 18-Selected potentially preventable hospitalisations, 2013

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, 2013
METeOR identifier:Help on this term497224
Registration status:Help on this termHealth, Superseded 30/04/2014
Description:Help on this termAdmissions to hospital that could have potentially been prevented through the provision of appropriate non-hospital health services.
Indicator set:Help on this termNational Healthcare Agreement (2013) Health, Superseded 30/04/2014
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on this termNational Healthcare Agreement: PI 18-Selected potentially preventable hospitalisations, 2013 QS Health, Superseded 14/01/2015

Collection and usage attributes

Computation description:Help on this term

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

 

Table 22 A: ICD-10-AM codes used for identifying potentially preventable hospitalisations

 

Category

ICD-10-AM codes

Vaccine-preventable

 

Influenza and pneumonia

J10, J11, J13, J14, J15.3, J15.4, J15.7, J15.9, J16.8, J18.1, J18.8 in any diagnosis field, excludes cases with additional diagnosis of D57 (sickle-cell disorders) and people under2 months

Other vaccine-preventable conditions

A35, A36, A37, A80, B05, B06, B16.1, B16.9, B18.0, B18.1, B26, G00.0, M01.4 in any diagnosis field

Chronic

 

Asthma

J45, J46 as principal diagnosis only

Congestive cardiac failure

I50, I11.0, J81 as principal diagnosis only, exclude cases with the following procedure codes: 33172-00, 38300-00, 38303-00, 38306-02, 38306-00, 38353-02, 38353-00, 38350-00, 38368-00, 38256-00, 38350-02, 38358-00, 38358-01, 38358-02, 38368-02, 38654-02, 38456-26, 38456-27, 38368-04, 38358-03, 38654-05, 38456-33, 38456-34, 38270-01, 38456-19, 38456-15, 38456-12, 38456-11, 38456-10, 90203-00, 38456-01, 38470-00, 38475-00, 38480-02, 38480-01, 38480-00, 38488-06, 38488-04, 38489-04, 38488-02, 38489-03, 38487-00, 38489-02, 38488-00, 38489-00, 38490-00, 38493-00, 38497-04, 38497-03, 38497-02, 38497-01, 38497-00, 38500-00, 38503-00, 38505-00, 38362-00, 90203-08, 90203-09, 38456-28, 38612-00, 38615-00, 38653-00, 38700-02, 38700-00, 38739-00, 38742-02, 38742-00, 38745-00, 38751-02, 38751-00, 38757-02, 38757-01, 38757-00, 90204-00, 90205-00, 90219-00, 90224-00

Diabetes complications

E10–E14.9 as principal diagnoses 

and E10–E14.9 as additional diagnoses where the principal diagnosis was:

–    hypersmolarity (E87.0)

–    acidosis (E87.2)

–    transient ischaemic attack (G45)

–    nerve disorders and neuropathies (G50–G64)

–    cataracts and lens disorders (H25–H28)

–    retinal disorders (H30–H36)

–    glaucoma (H40–H42)

–    myocardial infarction (I21–I22)

–    other coronary heart diseases (I20, I23–I25)

–    heart failure (I50)

–    stroke and sequelae (I60–I64, I69.0–I69.4)

–    peripheral vascular disease (I70–I74)

–    gingivitis and periodontal disease (K05)

–    kidney diseases (N00–N29) [including end-      stage renal disease (N17–N19)]

–    renal dialysis (Z49)

COPD

J20, J41, J42, J43, J44, J47 as principal diagnosis only, J20 only with additional diagnoses of J41, J42, J43, J44, J47

Angina

I20, I24.0, I24.8, I24.9 as principal diagnosis only, exclude cases with procedure codes not in blocks [1820] to [2016]

Iron deficiency anaemia

D50.1, D50.8, D50.9 as principal diagnosis only.

Hypertension

I10, I11.9 as principal diagnosis only, exclude cases with procedure codes according to the list of procedures excluded from the Congestive cardiac failure category above.

Nutritional deficiencies

E40, E41, E42, E43, E55.0, E64.3 as principal diagnosis only.

Rheumatic heart disease

I00 to I09 as principal diagnosis only. (Note: includes acute rheumatic fever)

Acute

 

Dehydration and gastroenteritis

A09.9, E86, K52.2, K52.8, K52.9 as principal diagnosis only.

Pyelonephritis

N10, N11, N12, N13.6, N39.0 as principal diagnosis only.

Perforated/bleeding ulcer

K25.0, K25.1, K25.2, K25.4, K25.5, K25.6, K26.0, K26.1, K26.2, K26.4, K26.5, K26.6, K27.0, K27.1, K27.2, K27.4, K27.5, K27.6, K28.0, K28.1, K28.2, K28.4, K28.5, K28.6 as principal diagnosis only.

Cellulitis

L03, L04, L08, L88, L98.0, L98.3 as principal diagnosis only, exclude cases with any procedure except those in blocks 1820 to 2016 or if procedure is 30316-02, 30676-00, 30223-02, 30064-00, 34528-02, 39127-00, 90661-00 and this is the only listed procedure

Pelvic inflammatory disease

N70, N73, N74 as principal diagnosis only.

Ear, nose and throat infections

H66, H67, J02, J03, J06, J31.2 as principal diagnosis only.

Dental conditions

K02, K03, K04, K05, K06, K08, K09.8, K09.9, K12, K13 as principal diagnosis only.

Appendicitis with generalised peritonitis

K35.2, K35.3 in any diagnosis field

Convulsions and epilepsy

G40, G41, O15, R56 as principal diagnosis only

Gangrene

R02 in any diagnosis field

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)

Calculated separately for each of the 3 computations:

  1. As per specification
  2. With diabetes complications (additional diagnoses only) and dehydration gastroenteritis excluded (Council of Australian Governments (COAG) Reform Council (CRC) supplementary data).
  3. With diabetes complications (all diagnoses) and dehydration gastroenteritis excluded (CRC supplementary data).
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, dehydration/gastroenteritis)
  • chronic conditions (e.g. diabetes, 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 2010-11
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 2010-11
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 2010-11
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 2010-11
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
Disaggregation:Help on this term

2008-09, 2009-10 (revised) and 2010–11—Nationally (by three groups and total) by SEIFA Index of Relative Socio-Economic Disadvantage (IRSD) deciles.

2008-09, 2009-10 (revised) and 2010–11—State and territory (by three groups and total), by:

  • Indigenous status  
  • remoteness (Australian Standard Geographical Classification Remoteness Structure)
  • SEIFA IRSD quintiles

2007-08, 2008-09, 2009-10, 2010-11 — Nationally, by Indigenous status by remoteness.

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, geographical location code (ASGC 2009) NNNNN
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2010-11
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 2010-11
Guide for use
Data source type: Administrative by-product data
Comments:Help on this term

Most recent data available for 2013 Council of Australian Governments (COAG) Reform Council (CRC) report: 2010–11.

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.

Potentially preventable hospitalisations are called ‘ambulatory care sensitive hospitalisations’ in some jurisdictions.

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, 2013

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 Health Performance Authority, Healthy Communities: Number of selected potentially avoidable hospitalisations per 100,000 people, 2011–12 National Health Performance Authority (retired), Retired 01/07/2016

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, 2013 Health, Superseded 30/04/2014

See also National Healthcare Agreement: PI 15-Effective management of diabetes, 2013 Health, Superseded 30/04/2014

See also National Healthcare Agreement: PI 16-Potentially avoidable deaths, 2013 Health, Superseded 30/04/2014

Has been superseded by National Healthcare Agreement: PI 18-Selected potentially preventable hospitalisations, 2014 Health, Superseded 14/01/2015

Supersedes National Healthcare Agreement: PI 22-Selected potentially preventable hospitalisations, 2012 Health, Superseded 25/06/2013

See also National Healthcare Agreement: PI 23-Unplanned hospital readmission rates, 2013 Health, Superseded 30/04/2014

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