KPIs for Australian Public Mental Health Services: PI 02J – 28 day readmission rate, 2015
Identifying and definitional attributes
|Metadata item type:||Indicator|
|Short name:||MHS PI 02J: 28 day readmission rate, 2015|
|Registration status:||Health, Standard 19/11/2015|
Proportion of in-scope overnight separations from state/territory acute admitted patient mental health care service unit(s) that are followed by readmission to the same or to another public sector acute admitted patient mental health care service unit within 28 days of discharge.
NOTE: This specification has been adapted from the indicator MHS PI 02: 28 day readmission rate, 2015 (Service level version) using terminology consistent with the National Health Data Dictionary. There are no technical differences in the calculation methodologies between the Service level version and the Jurisdictional level version of this indicator.
Readmissions to a psychiatric facility following a recent discharge may indicate that inpatient treatment was incomplete or ineffective, or that follow-up care was inadequate to maintain the person’s treatment out of hospital. In this sense, rapid readmissions may point to deficiencies in the functioning of the overall care system.
Avoidable rapid readmissions place pressure on finite beds and may reduce access to care for other consumers in need.
International literature identifies one month as an appropriate defined time period for the measurement of unplanned readmissions following separation from an acute psychiatric inpatient service.
|Indicator set:||Key Performance Indicators for Australian Public Mental Health Services (Jurisdictional level version) (2015) Health, Superseded 11/05/2016|
Collection and usage attributes
State/territory public acute admitted patient mental health care service units.
The following separations are excluded:
|Computation:||(Numerator ÷ Denominator) x 100|
|Numerator:||Number of in-scope overnight separations from state/territory 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 mental health care service unit within 28 days.|
|Numerator data elements:|
|Denominator:||Number of in-scope overnight separations from state/territory acute admitted mental health care service unit(s) occurring within the reference period.|
|Denominator data elements:|
Consumer attributes: Age, sex, SEIFA, remoteness, Indigenous status. Disaggregated data excludes missing or not reported data.
All disaggregation data are to be calculated as at the admission for the first index separation, even if the value is null. The index separation refers to the separation data point included in the denominator data set. The data at admission for the index separation should be used for the associated numerator data pair, when present, and any subsequent denominator and data pairs for a uniquely identifiable person.
|Disaggregation data elements:|
|Unit of measure:||Service event|
Indicator conceptual framework
|Framework and dimensions:||Effective|
|Reporting requirements:||State/territory supplied data.|
|Further data development / collection required:|
This indicator cannot be accurately constructed using the Admitted Patient Mental Health 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 Mental Health Care NMDS is required to enable unique identification of individual consumers across multiple years, multiple admitted episodes and multiple hospitals.
When data for this indicator are requested, jurisdictions are required to answer whether a state-wide unique client identifier system is in place, or some comparable approach has been used in the data analysis to allow tracking of service utilisation by an individual consumer across all public specialised mental health services in the jurisdiction. Collection of this information is aimed at assessing the degree of consistency between jurisdictions in data reported the result of which are explored in the data quality statement for this indicator.
|Other issues caveats:|
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.
Source and reference attributes
|Submitting organisation:||Australian Institute of Health and Welfare on behalf of the National Mental Health Performance Subcommittee|
|Reference documents:||Key Performance Indicators for Australian Public Mental Health Services, Third edition (2014)|
|Related metadata references:|
See also Specialised mental health service—admitted patient care program type, code N Health, Standard 08/12/2004, ACT Health, Final 17/08/2018