Safety and Quality > Our Work > Indicators of Safety and Quality > Avoidable Hospital Readmissions

A hospital readmission occurs when a patient has been discharged from hospital and is admitted again within a certain time interval.

Generally, hospital readmissions can be considered in two broad categories:

1.) readmissions that relate to routine care, for example those that relate to necessary treatments such as chemotherapy or dialysis, and are required to ensure safe clinical care;

2.) readmissions that are potentially avoidable.

Reducing avoidable hospital readmissions supports better health outcomes, improves patient safety and leads to greater efficiency in the health system.

Working definition of avoidable hospital readmissions

The Commission was tasked with developing a list of avoidable hospital readmissions to inform safety and quality reforms in Australia. In progressing this work, the Commission adopted the following working definition of ‘avoidable hospital readmissions’.

An avoidable hospital readmission occurs when a patient who has been discharged from hospital (index admission) is admitted again within a certain time interval, and the readmission:

  • Is clinically related to the index admission, and
  • Has the potential to be avoided through improved clinical management and/or appropriate discharge planning in the index admission.

List of conditions considered to be avoidable hospital readmissions

The following is the list of conditions considered to be avoidable hospital readmissions and associated condition-specific time intervals. The list was developed by the Commission and has been agreed by the Australian Health Ministers’ Advisory Council.

All Australian governments have committed to reforms under the National Health Reform Agreement Addendum, which include a focus on avoidable hospital readmissions. These reforms aim to integrate safety and quality into the pricing and funding of Australian public hospitals in a way that:

  • Improves patient outcomes
  • Provides an incentive in the system to provide the right care, in the right place, at the right time
  • Decreases avoidable demand for public hospital services
  • Signals to the health system the need to reduce instances of preventable poor quality patient care, while supporting improvements in data quality and information available to inform clinicians’ practice.

The reforms focus on reducing sentinel events, hospital-acquired complications and avoidable hospital readmissions.

Development of the list

At the request of the Australian Health Ministers’ Advisory Council, and in line with the National Health Reform Agreement Addendum, the Commission developed the list of conditions considered to be avoidable hospital readmissions.

This list of conditions, and the related condition-specific time intervals, was developed in consultation with clinical and consumer experts, taking into consideration:

  • Literature on avoidable hospital readmissions, and
  • Australian public hospital data, through analysis of the admitted patient care national minimum data set.

Next steps

The Independent Hospital Pricing Authority will be canvassing options for pricing and funding for avoidable readmissions in its Consultation Paper on the Pricing Framework for Australian Public Hospital Services 2019-20. The paper will be released on the Pricing Authority’s website on 12 June 2018 for a 30 day consultation period.

The Commission is also working with the Pricing Authority to finalise specifications for the list of avoidable hospital readmissions. These will include the related codes for each of the conditions. These specifications will be released on this website, along with further background, including the literature considered throughout the project.