Total number of enrolled patients with a hospital readmission in a given period within 30 days after a discharge for selected HIGs. 

Inclusions:

• Selected conditions (select HIGS) are: stroke, COPD, pneumonia, congestive heart failure, diabetes, cardiac conditions and gastrointestinal disorders.
• The hospitalization readmission is counted if:

a. the re-admission date is within 30 days of the index case discharge;

b. the DAD field “admission category” is urgent;

c. the admission is not coded as an acute transfer by receiving hospital (unless the readmission was coded as a transfer from the same hospital).

Exclusions:

• Records with missing or invalid discharge/admission date, health number, age or gender.

The numerator is the sum of all readmissions for all index cases in the reporting period.

Steps:

To obtain observed readmissions:

• Index cases (denominator) must be identified first.
• For each index case, identify whether there is a non-elective readmission to any facility within 30 days of discharge.

The hospitalization readmission is counted if:

• The readmission date is within 30 days of the index case discharge;
• DAD field “admission category” is urgent (non-elective readmission).

The hospitalization readmission is excluded if:

• The readmission case is coded as an acute transfer by the receiving hospital (unless the readmission was coded as a transfer from the same hospital).
• There is missing or invalid data for discharge date, admission date, health number, age or gender.

Total number of enrolled patients who were discharged for a selected condition (based on HIG) in a given period

Inclusions:

1. Patient with:

• Acute Myocardial Infarction AMI (age 45+)
• Cardiac conditions (excluding AMI and CHF) (age 40+)
• Congestive heart failure CHF (age 45+)
• Chronic obstructive pulmonary disease COPD (age 45+)
• Pneumonia
• Diabetes
• Stroke (age 45+)
• Gastrointestinal disease

2. Cases where the Inpatient HIG atypical code is either ‘00’ (typical cases), ‘01’ (transfer in cases), ‘09’ (short stay outlier cases), ‘10’ (long stay outlier cases), or ‘11’ (transfer in long stay cases).

Exclusions: 

• Records with missing valid data on discharge/admission date, health number, age or gender;
• Index cases coded as transfers to another acute inpatient hospital, deaths, and sign-outs; 3. Exclude cases with Discharge disposition = ‘07’ (death)

The denominator is the sum of all index cases (discharges in the reporting period for selected HIGs).

Steps:

Identify index cases:

       1. The index hospitalization is counted if: 

                a.The discharge date falls in the reporting period; 

                b.The HIG Group and patient age restrictions match those listed in the appendix; 

       2. The Inpatient HIG atypical code is ‘00’ (typical cases), ‘01’ (transfer        

           in cases), ‘09’ (short stay outlier cases), ‘10’ (long stay outlier   

           cases), or ‘11’ (transfer in long stay cases). The index           

           hospitalization is excluded if the case is coded as a transfer to 

           another acute inpatient hospital (unless the readmission was

           coded as a transfer from the same hospital).

       3. The denominator is the sum of all index cases in the reporting