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National Healthcare Agreement: PI 23–Unplanned hospital readmission rates, 2018

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, 2018
METeOR identifier:Help on this term658485
Registration status:Help on this termHealth, Standard 30/01/2018
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 (2018) Health, Standard 30/01/2018
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: PI 23-Unplanned hospital readmission rates, 2018 QS Health, Standard 30/01/2018

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 (9th 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 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 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 (9th 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

Hip replacement

49318–00

Total arthroplasty of hip, unilateral

 

49319–00

Total arthroplasty of hip, bilateral

Tonsillectomy and adenoidectomy

41789–00

Tonsillectomy without adenoidectomy

 

41789–01

Tonsillectomy with adenoidectomy

 

41801–00

Adenoidectomy without tonsillectomy

Hysterectomy

35653–01

Total abdominal hysterectomy

 

35653–04

Total abdominal hysterectomy with removal of adnexa

 

35661–00

Abdominal hysterectomy with extensive retroperitoneal dissection

 

35670–00

Abdominal hysterectomy with radical excision of pelvic lymph nodes

 

90448–01

Total laparoscopic abdominal hysterectomy

 

90448–02

Total laparoscopic abdominal hysterectomy with removal of adnexa

 

35657–00 Vaginal hysterectomy

 

35673–02

Vaginal hysterectomy with removal of adnexa

 

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

 

90408–00

Other destruction of lesion of prostate

 

37207–01

Endoscopic laser excision of prostate

 

37200–03

Subrapubic prostatectomy

 

37200-04

Retropubic prostatectomy

 

37224-00

Endoscopic destruction of lesion of prostate

 

37224–01

Endoscopic resection of lesion of prostate

 

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 extraction of crystalline lens by mechanical phacofragmentation and aspiration of cataract

 

42702–06

Extracapsular extraction of crystalline lens by mechanical phacofragmentation and aspiration of cataract with insertion of foldable artificial lens

 

42702–07

Extracapsular extraction of crystalline lens 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

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 SetPerson—person identifier, XXXXXX[X(14)]
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2015-16
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetEstablishment—sector, code N
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2015-16
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetEpisode of admitted patient care—admission date, DDMMYYYY
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2015-16
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetEpisode of admitted patient care—separation date, DDMMYYYY
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2015-16
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetEpisode of care—principal diagnosis, code (ICD-10-AM 9th edn) ANN{.N[N]}
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2015-16
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetEstablishment—organisation identifier (state/territory), NNNNN
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2015-16
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 SetEstablishment—sector, code N
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2015-16
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetEpisode of admitted patient care—procedure, code (ACHI 9th edn) NNNNN-NN
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2015-16
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetEpisode of admitted patient care—admission date, DDMMYYYY
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2015-16
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetEpisode of admitted patient care—separation date, DDMMYYYY
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2015-16
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetEstablishment—organisation identifier (state/territory), NNNNN
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2015-16
Disaggregation:Help on this term

2015–16—Nationally, by specified procedures, by:

  • peer group
  • Indigenous status
  • remoteness (Australian Statistical Geography Standard (ASGS) Remoteness Structure)
  • 2011 SEIFA IRSD quintiles

2015–16—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 SetEstablishment—Australian state/territory identifier, code N
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2015-16
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetPerson—Indigenous status, code N
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2015-16
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetPerson—area of usual residence, statistical area level 2 (SA2) code (ASGS 2011) N(9)
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2015-16
Guide for use

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


Data Element / Data SetEstablishment—organisation identifier (state/territory), NNNNN
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2015-16
Guide for use

Data source type: Administrative by-product data

Used to derive hospital peer group


Data Element / Data SetEpisode of admitted patient care—procedure, code (ACHI 9th edn) NNNNN-NN
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2015-16
Guide for use

Data source type: Administrative by-product data


Comments:Help on this term

Most recent data available for 2018 National Healthcare Agreement performance reporting: 2015–16.

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 2015–16 data, the 2011 SEIFA IRSD quintile and decile data will be produced using the Australian Statistical Geography Standard 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 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


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 National Healthcare Agreement: PI 16–Potentially avoidable deaths, 2018 Health, Standard 30/01/2018

See also National Healthcare Agreement: PI 18–Selected potentially preventable hospitalisations, 2018 Health, Standard 30/01/2018

See also National Healthcare Agreement: PI 22–Healthcare associated infections: Staphylococcus aureus bacteraemia, 2018 Health, Standard 30/01/2018

Supersedes National Healthcare Agreement: PI 23–Unplanned hospital readmission rates, 2017 Health, Superseded 30/01/2018

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