"Identifying Information: Name","Surgical Patients Readmitted to Hospital"
"Identifying Information: Short/Other Names","30-Day Surgical Readmission"
"Identifying Information: Description","This indicator measures the risk-adjusted rate of urgent readmission for the surgical patient group.For further details, please see the General Methodology Notes (PDF)."
"Background, Interpretation and Benchmarks: Rationale","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, effectiveness of the care transition and coordination, and the availability and use of effective community-based disease management programs. While not all urgent readmissions are avoidable, interventions during and after a hospitalization can be effective in reducing readmission rates."
"Background, Interpretation and Benchmarks: Interpretation","Lower rates are desirable."
"Background, Interpretation and Benchmarks: HSP Framework Dimension","Appropriate and effective"
"Background, Interpretation and Benchmarks: Areas of Need","Getting Better"
"Background, Interpretation and Benchmarks: Targets/Benchmarks","Not applicable"
"Available Data Years","2010
 to 2023"
"Available Data Years: Type of Year",Fiscal
"Availability of Results: Geographic Coverage","All provinces/territories"
"Reporting Level/Disaggregation",National
"Result Updates: Indicator Results","Web Tool:Your ºìÁì½í¹Ï±¨ System: In DepthPDF:Accessing Indicator Results on Your ºìÁì½í¹Ï±¨ System: In Depth (PDF)"
"Update Frequency","Every year"
"Result Updates: Latest Results Update Date","December 2024"
"Result Updates: Updates","Not applicable"
"Indicator Calculation: Description","Risk-adjusted rate = Observed number of readmissions ÷ Expected number of readmissions × Canadian average readmission rateUnit of analysis: Episode of careAn 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.NotesFor public reporting: Regional and provincial/territorial results are calculated by place of residence; facility results are calculated by place of service.For facility-level reporting: For episodes of care that involved transfers, readmissions were attributed to the last hospital from which the patient was discharged before readmission."
"Indicator Calculation: Type of Measurement",Rate
"Indicator Calculation: Number or Rate","per 100"
"Denominator: Description:","Number of surgical episodes of care discharged between April 1 and March 1 of the fiscal year"
"Denominator: Inclusions:","Episodes involving inpatient care (Facility Type Code = 1). An episode may start or end in a day surgery setting. Episodes that both start and end in day surgery settings are not included.Episodes involving surgical inpatient care (major clinical category [MCC] partition code = I [Intervention])Discharge between April 1 and March 1 of the following year (period of case selection ends on March 1 of the following year to allow for 30 days of follow-up)Age at admission 18 years and olderSex recorded as male or female"
"Denominator: Exclusions:","Records with an invalid health card numberRecords with an invalid code for province issuing health card numberRecords with an invalid admission date or timeRecords with an invalid discharge date or timeRecords with admission category of cadaveric donor or stillbirth (Admission Category Code = R or S)Episodes with discharge as death (DAD Discharge Disposition Code = 07, 72*, 73*, 74*; NACRS Visit Disposition Code = 10, 11, 71*, 72*, 73*, 74*)Presence of at least one record in the episode with MCC of Mental Diseases and Disorders (MCC = 17)Presence of at least one record in the episode with MCC of Pregnancy and Childbirth (MCC = 13)Presence of at least one record in the episode with palliative care (ICD-10-CA: Z51.5) coded as most responsible diagnosis (MRDx); for Quebec data: Z51.5 coded as MRDx, or cancer (C00–C97) coded as MRDx and Z51.5 coded in any secondary diagnosis fieldNote*2018–2019 data onwardFor an illustration of denominator selection, please refer to the flowchart in the General Methodology Notes (PDF) document."
"Numerator: Description:","Cases within the denominator with a non-elective readmission within 30 days of discharge after the index episode of care"
"Numerator: Inclusions:","Emergent or urgent (non-elective) readmission to an acute care hospital (Admission Category Code = U and Facility Type Code = 1)(Admission date on readmission record) − (Discharge date on the last record of the index episode of care) less than or equal to 30 days"
"Numerator: Exclusions:","Presence of at least one record in the episode with one of the following:Delivery (ICD-10-CA: O10–O16, O21–O29, O30–O37, O40–O46, O48, O60–O69, O70–O75, O85–O89, O90–O92, O95, O98, O99 with a sixth digit of 1 or 2; or Z37 recorded in any diagnosis field)Chemotherapy for neoplasm (ICD-10-CA: Z51.1) as type (M), (1), (C), (W), (X) or (Y)Admission for mental illness (MCC = 17)Admission for palliative care (ICD-10-CA: Z51.5) coded as MRDx; for Quebec data: Z51.5 coded as MRDx, or cancer (C00–C97) coded as MRDx and Z51.5 coded in any secondary diagnosis field2018–2019 data onward: Medical assistance in dying (MAID) (Discharge Disposition Code = 73)Records with an invalid admission date"
"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."
"Indicator Calculation: Geographic Assignment","Place of residence or service"
"Data Sources",DAD
"Quality Statement: Caveats and Limitations","Not applicable"
"Quality Statement: Trending Issues","Not applicable"
"Quality Statement: Comments","Indicator results are also available inThe ºìÁì½í¹Ï±¨ Indicators e-Publication (at regional, provincial/territorial and national levels, calculated by place of residence), starting from 2010–2011Your ºìÁì½í¹Ï±¨ System: Insight, updated monthly (results are available by both place of residence and place of service)"
References,"Ashton CM, Wray NP. A Conceptual Framework for the Study of Early Readmission as an Indicator of Quality of Care. Soc Sci Med 1996;(43):1533-1541.Feudtner C. State-Level Child ºìÁì½í¹Ï±¨ System Performance and the Likelihood of Readmission to Children's Hospitals. The Journal of Pediatrics. 2010;(157):98-102.Jencks SF, et al. Rehospitalizations Among Patients in the Medicare Fee-for-Service Program. N Engl J Med 2009;(360):1418-1428.Jiang HJ, Wier LM. All-Cause Hospital Readmissions Among Non-Elderly Medicaid Patients, 2007. HCUP Statistical Brief #89. Rockville, MD: AHRQ; 2010.Liu S, Heaman M, Joesph KS, et al. Risk of Maternal Postpartum Readmission Associated With Mode of Delivery. Obstet Gynecol Int 2005;(105):836-842.Stone J, Hoffman G J. Medicare Hospital Readmissions: Issues, Policy Options and PPACA. Washington, DC: CRS; 2010."