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INDICATOR NAME
Name
Hospital readmissions for mental health or addiction
Alternate Name
Percentage of patients 16 and older hospitalized for a mental illness or addiction who were readmitted to hospital for a mental illness or addiction within 30 days of discharge
 
INDICATOR DESCRIPTION
Description
This indicator measures the percentage of psychiatric (mental health or addiction) discharges that are followed within 30 days by another mental health or addiction hospital admission.   
 
Indicator Status
Active
HQO Reporting tool/product
Public reporting
Dimension
Effective
Type
Outcome
 
DEFINITION AND SOURCE INFORMATION
Unit of Measurement
Percentage
Calculation Methods
Numerator divided by the denominator times 100
Numerator including inclusion/exclusion

Number of individuals with any mental health or addictions hospital readmissions* within (≤) 30 days following the incident hospital discharge

Notes:
 
 1. Separately report the number of individuals who died and re-admitted during the follow-up period overall in all years.
 2. Calculate within (≤) 30 days acute care re-admission proportion following the index MH&A hospital discharge date (i.e. Count only one visit per IKN per 30 day follow-up period).
 3. Reason for re-admission can be for a different MH&A reason than the initial MH&A diagnosis.
 4. Incident discharges are restricted to calendar years but 30 day follow-up for readmission can cross over into the next calendar year.
 
Exclusions  (apply to both numerator and denominator):
 
 5. Invalid IKN
 6. Non-Ontario resident (1st two characters of PRCDDA ne ‘35’)
 7. Missing sex
 8. Age < 16, > 105
 9. Adults who die within 30 days of discharge (based on RPDB)

Denominator including inclusion/exclusion

Total number of incident mental health or addictions hospital discharges between calendar years of interest

Incident = 1stevent in a calendar period without any look-back for past events (If multiple hospital visits in CY, use first). Keep only one discharge per IKN per year.
 
Age ranges to include: >16, <=105
 
Exclude:
 
 1. Patients without a valid health insurance number
 2. Patients without an Ontario residence
 3. Gender not recorded as male or female
 4. or Age > 105
 5. Invalid date of birth, admission date/time, discharge date/time
 6. Individuals who die within 30 days of discharge (based on RPDB) before a follow-up or outcome occurs (i.e. a person dies before they have been readmitted or is readmitted but dies before they are discharged)
 
Note: For OMHRS records if admission to an institution or occurs within 24 hours of discharge from institution then this should be considered as part of the same episode of care.
 

Adjustment (risk, age/sex standardization)- detailed
Age- and sex-standardized to the 2006 Ontario census population
Data Source
Discharge Abstract Database (DAD), Ontario Mental Health Reporting System (OMHRS), Registered Persons Database (RPDB)
Data provided to HQO by
Institute for Clinical Evaluative Sciences (ICES)
Reported Levels of comparability /stratifications (defined)
Age, Income, Region, Rurality, Sex, Time
 
OTHER RELEVANT INFORMATION
Caveats and Limitations
Limitations include potential coding errors and a lack of clinical detail. Data did not capture non-physician mental health and addictions services that may have been provided in the period between hospital discharge and readmission.
Footnotes
1 Health Indicators 2011. In Focus: Snapshot of the Performance of the Mental health System 2 Vigod S, Taylor V, Fung K, Kurdyak P. Within-hospital readmission: An indicator of readmission after discharge from psychiatric hospitalization.
 
TAGS
Sector
Acute Care/Hospital
Type
Outcome
Topic
Mental Health and Addiction, Readmission
Dimension
Effective
Source
Discharge Abstract Database (DAD), Ontario Mental Health Reporting System (OMHRS), Registered Persons Database (RPDB)
 
PUBLISH
Publish Datetime
20/11/2018 15:46:00