NMHP PI 14 Readmission to hospital within 28 days of discharge

• Strategic issue - Service Access, Coordination and Continuity of Care.
  
  
• Rationale - Readmission rate is considered a global performance measure, as it potentially points to deficiencies in the functioning of the overall care system. Admissions to a psychiatric facility following a recent discharge may indicate that inpatient treatment was either incomplete or ineffective, or that follow-up care was inadequate to maintain the person out of hospital.
  
  
• Endorsement status - Endorsed by AHMAC Mental Health Standing Committee, February 2011.
  
  
• Date last updated - January 2011.

Indicator details
National Mental Health Performance Framework
Data collection details

Indicator details

• Description - Percentage of in-scope overnight separations from the mental health service organisation's acute psychiatric inpatient units that are followed by a readmission to the same or to another public sector psychiatric inpatient unit within 28 days of discharge.
  
  
• Numerator - Number of in-scope overnight separations from the mental health service organisation's acute psychiatric inpatient unit(s) occurring within the reference period, that are followed by a readmission to the same or another acute psychiatric inpatient unit within 28 days.
  
  
• Denominator - Number of in-scope overnight separations from the mental health service organisation's acute psychiatric inpatient unit(s) occurring within the reference period.
  
  
• Computation - (Numerator ÷ Denominator) x 100.
  
  Calculated separately for public, private and MBS-funded services.
  
  
• Calculation conditions
  
  
  • Coverage/Scope - All public mental health service organisations acute psychiatric inpatient units.
    
    The following separations are excluded:
    
    
    • Same day separations, including index separation and subsequent readmission.
      
      
    • Statistical and change of care type separations.
      
      
    • Separations that end by transfer to another acute or psychiatric inpatient hospital.
      
      
    • Separations that end by death, left against medical advice/ discharge at own risk.Separations, where purpose of admission was for maintenance ECT and length of stay is one night only.
  • Methodology - Readmission is considered to have occurred if the person has been admitted to any public sector mental health acute inpatient unit within the state/territory. As such a state-wide unique patient identifier is required for full implementation of this indicator.
    
    Where a mental health service organisation has more than one unit of a particular service type for the purpose of this indicator those units should be combined.
• Definitions
  
  
  • 'Same day separations' are inpatient episodes where the admission and separation dates are the same.
    
    
  • 'Same or another acute psychiatric inpatient unit' for the purposes of this indicator 'another' means within the same jurisdiction..
• Presentation - Percentage.
  
  
• Disaggregation - State/Territory and age.
  
  
• Notes
  
  
  • This indicator cannot differentiate between 'planned' and 'unplanned' readmissions.
    
    
  • This indicator will not track readmissions across state/territory boundaries or track movement between public and private hospitals.
• Is specification interim or long-term? - Long-term.
  
  
• Reported in:
  
  
  • COAG National Action Plan Progress Report (Indicator 8 Readmission to hospital within 28 days of discharge).
    
    
  • Report on Government Services.

Top of page

National Mental Health Performance Framework

• Tier - Tier III - Health System Performance.
  
  
• Primary domain - Effective.
  
  
• Secondary domain(s) - Continuous.
  
  
• Mental health sub-domain - Community tenure.
  
  
• Type of measure - Outcome.
  
  
• Level at which indicator can be useful for benchmarking
  
  
  • Service Unit.
  • Regional group of services.
  • Mental Health Service Organisation.
  • State/Territory.
• Related performance indicators and performance benchmarks
  
  
  • Rates of pre-admission community care.
  • Rates of post-discharge community care.

Data collection details

• Data source(s)
  
  
  • Numerator - State/territory admitted patient data.
  • Denominator - State/territory admitted patient data.
• Data source(s) type
  
  
  • Numerator - Administrative.
  • Denominator - Administrative.
• Frequency of data source(s) collection
  
  
  • Numerator - Annually.
  • Denominator - Annually.
• Data development
  
  
  • Long-term - Data linkage may allow identification of readmission between jurisdictions, and between public and private hospitals.

Top of page