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Emergency readmission following discharge (adults)

Emergency readmissions to hospital within 28 days of discharge, as a percentage of live discharges for patients aged 16 years and over

Rationale

Previous analyses have shown that around 9% of patients discharged from NHS hospitals (excluding day cases) are readmitted as an emergency within 28 days. There is wide variation between 'like' populations in rates of such admissions. Emergency readmissions are unlikely to be part of the originally planned treatment and some may be potentially avoidable. The NHS may be helped to prevent potentially avoidable readmissions by seeing comparative figures and learning lessons from the experience of hospitals with low readmission rates.

The quality of data provided by trusts to the national Hospital Episode Statistics (HES) database is variable and sometimes unsatisfactory. Clinical focus indicators which use HES data, such as this indicator, include an assessment of data quality and trusts with unsatisfactory data are penalised.

Thresholds

Legend
Band 1 - poor Value below 99.9% lower limit of expected distribution
Band 2 Value between 99.9% and 97.5% lower limits of expected distribution
Band 3 Value within the central 95% probability limits of expected distribution
Band 4 Value between 99.9% and 97.5% higher limits of expected distribution
Band 5 - good Value above higher 99.9% limit of expected distribution

Data source and period

Hospital Episode Statistics (Calendar Year 2004)

Construction

Numerator:
(Number of readmissions) Number of finished and unfinished spells that are emergency admissions within 28 days of a discharge from hospital meeting the denominator criteria.

Denominator:
(Relevant consultant episodes) Number of spells within medical and surgical specialties with a discharge date within the year of analysis up to the 4th December 2004. Day cases, maternity spells and those with a diagnosis of cancer are excluded.

Indicator:
A detailed technical specification (construction) is available via the link on this page.

More information on different aspects of the calculation of HES based clinical indicators is available in documents on data quality and construction of continuous inpatient spells (via "more information" link on website). A paper on statistical methods will follow in due course.

Expressed as a percentage.


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