Versions Compared

Key

  • This line was added.
  • This line was removed.
  • Formatting was changed.
HTML
<div id="summaryView" role="tabpanel" aria-labelledby="tabSummaryView">
HTML Table
classconfluenceTable
Table Row (tr)
Table Cell (td)
Name
Table Cell (td)
Surgical Patients Readmitted to Hospital
Table Row (tr)
Table Cell (td)
Short/Other Names
Table Cell (td)

30-Day Surgical Readmission

Table Row (tr)
Table Cell (td)
Description
Table Cell (td)

This indicator measures the risk-adjusted rate of urgent readmission for the surgical patient group.

For further details, please see the General Methodology Notes.

Table Row (tr)
Table Cell (td)
Interpretation
Table Cell (td)
Lower rates are desirable.
Table Row (tr)
Table Cell (td)
HSP Framework Dimension
Table Cell (td)

Health System Outputs: Appropriate and effective

Table Row (tr)
Table Cell (td)
Areas of Need
Table Cell (td)

Getting Better

Table Row (tr)
Table Cell (td)
Geographic Coverage
Table Cell (td)

All provinces/territories

Table Row (tr)
Table Cell (td)
Reporting Level/Disaggregation
Table Cell (td)

National, Province/Territory, Region, Facility, Neighbourhood Income Quintile

Table Row (tr)
Table Cell (td)
Indicator Results
Table Cell (td)

Accessing Indicator Results on Your Health System: In Depth

HTML
</div>
HTML
<div id="fullView" role="tabpanel" aria-labelledby="tabFullView">
HTML

<div role="button" class="expandableTitle" aria-controls="identifyingInfoRegion">Identifying Information</div>
HTML Table
ididentifyingInfoRegion
Table Row (tr)
Table Cell (td)
Name
Table Cell (td)
Surgical Patients Readmitted to Hospital
Table Row (tr)
Table Cell (td)
Short/Other Names
Table Cell (td)

30-Day Surgical Readmission

HTML

<div role="button" class="expandableTitle" aria-controls="descAndCalRegion">Indicator Description and Calculation</div>
HTML Table
iddescAndCalRegion
Table Row (tr)
Table Cell (td)
Description
Table Cell (td)

This indicator measures the risk-adjusted rate of urgent readmission for the surgical patient group.

For further details, please see the General Methodology Notes.

Table Row (tr)
Table Cell (td)
Calculation: Description
Table Cell (td)

Risk-adjusted rate = Observed number of readmissions ÷ Expected number of readmissions × Canadian average readmission rate

Unit of analysis: Episode of care

An episode of care refers to all contiguous inpatient hospitalizations and same-day surgery visits. For episodes with transfers within or between facilities, transactions were linked regardless of diagnoses. To construct an episode of care, a transfer is assumed to have occurred if either of the following conditions is met:

a) An acute care hospitalization or a same-day surgery visit occurs less than seven hours after discharge from the previous acute care hospitalization or same-day surgery visit, regardless of whether the transfer is coded;

b) An acute care hospitalization or same-day surgery visit occurs between 7 and 12 hours after discharge from the previous acute care hospitalization or same-day surgery visit, and at least one of the hospitalizations or visits has coded the transfer.

Notes

  • For public reporting: Regional and provincial/territorial results are calculated by place of residence; facility results are calculated by place of service.
  • For facility-level reporting: For episodes of care that involved transfers, readmissions were attributed to the last hospital from which the patient was discharged before readmission.
Table Row (tr)
Table Cell (td)
Calculation: Geographic Assignment
Table Cell (td)

Place of residence or service

Table Row (tr)
Table Cell (td)
Calculation: Type of Measurement
Table Cell (td)

Rate - per 100

Table Row (tr)
Table Cell (td)
Calculation: Adjustment Applied
Table Cell (td)

The following covariates are used in risk adjustment:
For a detailed list of covariates used in the model, please refer to the Model Specification document.

Table Row (tr)
Table Cell (td)
Calculation: Method of Adjustment
Table Cell (td)

Logistic regression

Table Row (tr)
Table Cell (td)
Denominator
Table Cell (td)

Description:
Number of surgical episodes of care discharged between April 1 and March 1 of the fiscal year
Inclusions:
1. Episodes involving inpatient care (Facility Type Code = 1). An episode may start or end in a day surgery setting. Episodes that both start and end in day surgery settings are not included.

2. Episodes involving surgical inpatient care (major clinical category [MCC] partition code = I [Intervention])

3. Discharge between April 1 and March 1 of the following year (period of case selection ends on March 1 of the following year to allow for 30 days of follow-up)

4. Age at admission 20 years and older

5. Sex recorded as male or female
Exclusions:
1. Records with an invalid health card number

2. Records with an invalid code for province issuing health card number

3. Records with an invalid admission date or time

4. Records with an invalid discharge date or time

5. Records with admission category of cadaveric donor or stillbirth (Admission Category Code = R or S)

6. Episodes with discharge as death, self sign-out or patient not returning from a pass (DAD Discharge Disposition Code = 07, 72,* 73,* 74,* 06, 61,* 62,* 12, 65,* 66* or 67*; NACRS Visit Disposition Code = 10, 11, 71,* 72,* 73,* 74,* 02, 03, 04, 05, 61,* 62,* 63,* 64,* 65,* 66* or 67*)

7. Presence of at least one record in the episode with MCC of Mental Diseases and Disorders (MCC = 17)

8. Presence of at least one record in the episode with MCC of Pregnancy and Childbirth (MCC = 13)

9. Presence of at least one record in the episode with palliative care (ICD-10-CA: Z51.5) coded as most responsible diagnosis (MRDx); for Quebec data: Z51.5 coded as MRDx, or cancer (C00–C97) coded as MRDx and Z51.5 coded in any secondary diagnosis field

Note
*2018–2019 data onward

For an illustration of denominator selection, please refer to the flowchart in the General Methodology Notes document.

Table Row (tr)
Table Cell (td)
Numerator
Table Cell (td)

Description:
Cases within the denominator with a non-elective readmission within 30 days of discharge after the index episode of care
Inclusions:
1. Emergent or urgent (non-elective) readmission to an acute care hospital (Admission Category Code = U and Facility Type Code = 1)

2. (Admission date on readmission record) − (Discharge date on the last record of the index episode of care) less than or equal to 30 days

Exclusions:
Presence of at least one record in the episode with one of the following:

1. Delivery (ICD-10-CA: O10–O16, O21–O29, O30–O37, O40–O46, O48, O60–O69, O70–O75, O85–O89, O90–O92, O95, O98, O99 with a sixth digit of 1 or 2; or Z37 recorded in any diagnosis field)

2. Chemotherapy for neoplasm (ICD-10-CA: Z51.1) as MRDx

3. Admission for mental illness (MCC = 17)

4. Admission for palliative care (ICD-10-CA: Z51.5) coded as MRDx; for Quebec data: Z51.5 coded as MRDx, or cancer (C00–C97) coded as MRDx and Z51.5 coded in any secondary diagnosis field

5. 2018–2019 data onward: Medical assistance in dying (MAID) (Discharge Disposition Code = 73)

6. Records with an invalid admission date

HTML

<div role="button" class="expandableTitle" aria-controls="backgroundRegion">Background, Interpretation and Benchmarks</div>
HTML Table
idbackgroundRegion
Table Row (tr)
Table Cell (td)
Rationale
Table Cell (td)

Readmissions to acute care facilities are increasingly being used to measure institutional or regional quality of care and care coordination.

Readmission rates can be influenced by a variety of factors, including the quality of inpatient and outpatient care, effectiveness of the care transition and coordination, and the availability and use of effective community-based disease management programs. While not all urgent readmissions are avoidable, interventions during and after a hospitalization can be effective in reducing readmission rates.

Table Row (tr)
Table Cell (td)
Interpretation
Table Cell (td)

Lower rates are desirable.

Table Row (tr)
Table Cell (td)
HSP Framework Dimension
Table Cell (td)

Health System Outputs: Appropriate and effective

Table Row (tr)
Table Cell (td)
Areas of Need
Table Cell (td)

Getting Better

Table Row (tr)
Table Cell (td)
Targets/Benchmarks
Table Cell (td)

Not applicable

Table Row (tr)
Table Cell (td)
References
Table Cell (td)

Ashton CM, Wray NP. A Conceptual Framework for the Study of Early Readmission as an Indicator of Quality of Care. Soc Sci Med 1996;(43):1533-1541.

Feudtner C. State-Level Child Health System Performance and the Likelihood of Readmission to Children's Hospitals. The Journal of Pediatrics. 2010;(157):98-102.

Jencks SF, et al. Rehospitalizations Among Patients in the Medicare Fee-for-Service Program. N Engl J Med 2009;(360):1418-1428.

Jiang HJ, Wier LM. All-Cause Hospital Readmissions Among Non-Elderly Medicaid Patients, 2007. HCUP Statistical Brief #89. Rockville, MD: AHRQ; 2010.

Liu S, Heaman M, Joesph KS, et al. Risk of Maternal Postpartum Readmission Associated With Mode of Delivery. Obstet Gynecol Int 2005;(105):836-842.

Stone J, Hoffman G J. Medicare Hospital Readmissions: Issues, Policy Options and PPACA. Washington, DC: CRS; 2010.

HTML

<div role="button" class="expandableTitle" aria-controls="availabilityRegion">Availability of Data Sources and Results</div>
HTML Table
idavailabilityRegion
Table Row (tr)
Table Cell (td)
Data Sources
Table Cell (td)

DAD, HMDB, NACRS

Table Row (tr)
Table Cell (td)
Available Data Years
Table Cell (td)

Type of Year:
Fiscal
First Available Year:
2010
Last Available Year:
2017

Table Row (tr)
Table Cell (td)
Geographic Coverage
Table Cell (td)

All provinces/territories

Table Row (tr)
Table Cell (td)
Reporting Level/Disaggregation
Table Cell (td)

National, Province/Territory, Region, Facility, Neighbourhood Income Quintile

HTML

<div role="button" class="expandableTitle" aria-controls="resultRegion">Result Updates</div>
HTML Table
idresultRegion
Table Row (tr)
Table Cell (td)
Update Frequency
Table Cell (td)

Every year

Table Row (tr)
Table Cell (td)
Indicator Results
Table Cell (td)

Web Tool:
Your Health System: In Depth
URL:
Accessing Indicator Results on Your Health System: In Depth

Table Row (tr)
Table Cell (td)
Updates
Table Cell (td)

Not applicable

HTML

<div role="button" class="expandableTitle" aria-controls="qualityRegion">Quality Statement</div>
HTML Table
idqualityRegion
Table Row (tr)
Table Cell (td)
Caveats and Limitations
Table Cell (td)

Not applicable

Table Row (tr)
Table Cell (td)
Trending Issues
Table Cell (td)

Not applicable

Table Row (tr)
Table Cell (td)
Comments
Table Cell (td)

Indicator results are also available in

HTML
</div>