All Patients Readmitted to Hospital
Lower rates are desirable.
Risk-adjusted rate for each facility = Observed number of readmissions for each facility ÷ Expected number of readmissions for the facility × 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:
- 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
- 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
For episodes of care that involved transfers, readmissions were attributed to the last hospital from which the patient was discharged before readmission.
Obstetric, pediatric, surgical and medical episodes of care discharged between April 1 and March 1 of the fiscal year
Cases within the denominator with an urgent readmission within 30 days of discharge after the index episode of care
Methodology
Name
All Patients Readmitted to Hospital
Short/Other Names
30-Day Overall Readmission
Description
This indicator measures the risk-adjusted rate of urgent readmissions within 30 days of discharge for episodes of care for the following patient groups: obstetric, pediatric, surgical and medical.
For further details, please see the General Methodology Notes (PDF).
Rationale
Urgent 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, the effectiveness of the care transition and coordination, and the availability and use of effective disease management community-based programs. While not all unplanned readmissions are avoidable, interventions during and after a hospitalization can be effective in reducing readmission rates.
Interpretation
Lower rates are desirable.
HSP Framework Dimension
Health system outputs: Appropriate and effective
Areas of Need
Getting Better
Targets/Benchmarks
Not applicable
Available Data Years
to (fiscal years)
Geographic Coverage
- All provinces/territories
Reporting Level/Disaggregation
- National
- Province/Territory
- Region
- Facility
Indicator Results
Update Frequency
Every year
Latest Results Update Date
Updates
Not applicable
Description
Risk-adjusted rate for each facility = Observed number of readmissions for each facility ÷ Expected number of readmissions for the facility × 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:
- 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
- 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
For episodes of care that involved transfers, readmissions were attributed to the last hospital from which the patient was discharged before readmission.
Type of Measurement
Rate - per 100
Denominator
Description:
Obstetric, pediatric, surgical and medical episodes of care discharged between April 1 and March 1 of the fiscal year
Inclusions:
Numerator
Description:
Cases within the denominator with an urgent readmission within 30 days of discharge after the index episode of care
Inclusions:
Method of Adjustment
Logistic regression
Adjustment Applied
Covariates used in risk adjustment:
For a detailed list of covariates used in the model, please refer to the Model Specification (PDF) document for the covariates used in risk adjustment for each of the four specific patient group readmission indicators for details (obstetric, pediatric, surgical and medical).
Geographic Assignment
Place of service
Data Sources
- DAD
- HMDB
- NACRS
Caveats and Limitations
Not applicable
Trending Issues
Not applicable
References
Friedman B, Basu J. The rate and cost of hospital readmissions for preventable conditions. Med Care Res Rev June, 2004;61(2):225-240.
Halfon P, Eggli Y, Pretre-Rohrbach I, Meylan D, Marazzi A, Burnand B. Validation of the potentially avoidable hospital readmission rate as a routine indicator of the quality of hospital care. Med Care November, 2006;44(11):972-981.
Misky GJ, Wald HL, Coleman EA. Post-hospitalization transitions: Examining the effects of timing of primary care provider follow-up. J Hosp Med (Online) September, 2010;5(7):392-397.
Rumball-Smith J, Hider P. The validity of readmission rate as a marker of the quality of hospital care, and a recommendation for its definition. Review 39 refs. N Z Med J February 13, 2009;122(1289):63-70.
Shepperd S, McClaran J, Phillips CO, et al. Discharge planning from hospital to home. Review 83 refs. Update of Cochrane Database Syst Rev. 2004;(1):CD000313; PMID: 14973952. Cochrane Database of Systematic Reviews (1):CD000313, 2010. 2010;(1):CD000313.
How to cite:
Canadian Institute for Health Information. All Patients Readmitted to Hospital . Accessed April 24, 2025.
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Comments
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