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Australian Health Performance Framework: PI 2.4.1–Unplanned hospital readmission rates, 2019

Identifying and definitional attributes

Metadata item type:Help on this termIndicator
Indicator type:Help on this termIndicator
Short name:Help on this termAHPF PI 2.4.1–Unplanned hospital readmission rates, 2019
METeOR identifier:Help on this term715368
Registration status:Help on this termHealth, Standardisation pending 03/12/2019
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 termAustralian Health Performance Framework, 2019 Health, Standardisation pending 03/12/2019

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 (10th 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 Intraoperative and postprocedural disorders of endocrine and metabolic system, not elsewhere classified

G97 Intraoperative and postprocedural disorders of nervous system, not elsewhere classified

H59 Intraoperative and postprocedural disorders of eye and adnexa, not elsewhere classified

H95 Intraoperative and postprocedural disorders of ear and mastoid process, not elsewhere classified

I97 Intraoperative and postprocedural disorders of circulatory system, not elsewhere classified

J95 Intraoperative and postprocedural disorders of respiratory system, not elsewhere classified

K91 Intraoperative and postprocedural disorders of digestive system, not elsewhere classified

M96 Intraoperative and postprocedural disorders of musculoskeletal system, not elsewhere classified

N99 Intraoperative and 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 (10th 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

 

49521–00

Total arthroplasty of knee with bone graft to femur, unilateral

 

49524–00

Total arthroplasty of knee with bone graft to femur and 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 37200–03 Suprapubic prostatectomy
  37200–04 Retropubic prostatectomy
  37224–00 Endoscopic destruction procedures on prostate
  37224–03 Endoscopic resection of prostate
  90407–00 Excision of other lesion of prostate
  90408–00 Destruction procedures on prostate
  90408–02 Other closed destruction procedures on prostate
  37209–01 Laparoscopic radical prostatectomy
  37210–01 Laparoscopic radical prostatectomy with bladder neck reconstruction
  37211–01 Laparoscopic radical prostatectomy with bladder neck reconstruction and pelvic lymphadenectomy
  37209–00 Radical prostatectomy
  37210–00 Radical prostatectomy with bladder neck reconstruction
  37211–00 Radical prostatectomy with bladder neck reconstruction and pelvic lymphadenectomy
  37200–05 Other open prostatectomy
  37203–06 Other closed prostatectomy
Cataract surgery 42698–05 Other extraction of crystalline lens
  42698–06 Intracapsular extraction of crystalline lens
  42698–07 Phacoemulsification of crystalline lens
  42698–08 Other extracapsular extraction of crystalline lens
  42731–01 Extraction of crystalline lens with removal of vitreous
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 2017-18
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 2017-18
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 2017-18
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 2017-18
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetEpisode of care—principal diagnosis, code (ICD-10-AM 10th edn) ANN{.N[N]}
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2017-18
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 2017-18
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 2017-18
Guide for use

Data source type: Administrative by-product data


Data Element / Data SetEpisode of admitted patient care—procedure, code (ACHI 10th edn) NNNNN-NN
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2017-18
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 2017-18
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 2017-18
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 2017-18
Guide for use

Data source type: Administrative by-product data


Disaggregation:Help on this term

2013–14, 2014–15, 2015–16, 2016–17, 2017–18—Nationally, by specified procedures.

Nationally, by specified procedures, by (all not reported):

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

2013–14, 2014–15, 2015–16, 2016–17, 2017–18—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 2017-18
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 2017-18
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 2016) N(9)
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2017-18
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 2017-18
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 10th edn) NNNNN-NN
Data Source
National Hospital Morbidity Database (NHMD)
NMDS / DSS
Admitted patient care NMDS 2017-18
Guide for use

Data source type: Administrative by-product data


Comments:Help on this term

Most recent data available for 2019 Australian Health Performance Framework reporting: 2017–18.

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 2017–18 data, the 2016 SEIFA IRSD quintile and decile data will be produced using the Australian Statistical Geography Standard 2016 geographical unit of Statistical Area Level 2.

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 term4. Continuity of care

Data source attributes

Data sources:Help on this term
Data SourceNational Hospital Morbidity Database (NHMD)
Frequency
Annual
Data custodian

Australian Institute of Health and Welfare


Accountability attributes

Reporting requirements:Help on this term

Australian Health Performance Framework

Organisation responsible for providing data:Help on this term

Australian Institute of Health and Welfare

Source and reference attributes

Reference documents:Help on this term

AIHW 2015. Australian hospital peer groups. Health services series no. 66. Cat. no. HSE 170. Canberra: AIHW. Viewed 7 November 2019, https://www.aihw.gov.au/reports/hospitals/australian-hospital-peer-groups/contents/table-of-contents.

Relational attributes

Related metadata references:Help on this term

See also Australian Health Performance Framework: PI 2.1.4–Selected potentially preventable hospitalisations, 2019 Health, Standardisation pending 03/12/2019

See also Australian Health Performance Framework: PI 2.1.6–Potentially avoidable deaths, 2019 Health, Standardisation pending 03/12/2019

See also National Healthcare Agreement: PI 18–Selected potentially preventable hospitalisations, 2020 Health, Standardisation pending 29/11/2019

See also National Healthcare Agreement: PI 23–Unplanned hospital readmission rates, 2020 Health, Standardisation pending 29/11/2019

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