This indicator measures the rate, per 100 patient discharges, of unplanned returns to a hospital within 30 days of discharge. It includes medical patients who were hospitalized for non-surgical treatment, and patients who had surgery while in hospital. A lower rate is better.
The number of episodes of care for medical and surgical patients with an urgent readmission within 30 days of previous discharge.
- Emergent or urgent (non-elective) readmission to an acute care hospital (it does not have to be the same facility as the index hospitalization).
- When the time between the admission date on readmission record and the discharge date on the last record of the index episode of care is less than or equal to 30 days.
Presence of at least one record in the episode with one of the following:
- 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).
- Chemotherapy for neoplasm (ICD-10-CA: Z51.1) as MRDx.
- Admission for mental illness (MCC = 17).
- Admission for palliative care (ICD-10-CA: Z51.5) coded as MRDx.
- Records with an invalid admission date.
The number of episodes of care discharged between April 1 and March 1 of the fiscal year for surgical and medical patients.
- Surgical Group MCC Partition Code = I (intervention)
- Medical Group MCC Partition Code = D (diagnosis) (not an intervention)
- Episodes involving inpatient care. An episode may start or end in a day surgery setting. Episodes that both start and end in day surgery settings are not included.
- Discharges 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).
- Sex recorded as male or female.
- Ontario resident.
- Age 20 and older.
- Records with an invalid health card number.
- Records with an invalid date of birth.
- Records with an invalid admission date or time.
- Records with an invalid discharge date or time.
- Records with an admission category of still birth or cadaveric donor.
- Episodes with a discharge of death or self sign-out.
- Presence of at least one record in the episode with MCC 17 (Mental Diseases and Disorders).
- Presence of at least one record in the episode with palliative care (ICD-10-CA: Z51.5) coded as most responsible diagnosis (MRDx).
- Presence of at least one record in the episode with MCC 13 (Pregnancy and Childbirth).
Risk adjustment factors: Age group, sex, acute care hospitalization in previous six months, urgent admission, Charlson Comorbidity score group* and selected CMG group**