Readmission to MedWard: Difference between revisions

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{{Reporting Indicators
{{Reporting Indicators
| description = Number of Ward readmission within 7 days per 100 discharges to hospital.
| description = Number of Ward readmission within 7 days per 100 discharges from discharging hospital.
| indicator_name = Readmission Rate to Med ward
| indicator_name = Readmission Rate to Med ward
| created_raw = Created   
| created_raw = Created   
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==Reported as==
==Reported as==
* Percent of total discharges to hospital (Rate)
* Percent of total discharges from discharging hospital (Rate)
 
{{DJ |
* when we were setting up [[LAU collection readmission data]] we realized that we are not clear on what exactly is included in a [[Discharged to community]]. We should decide how to define that and whether it should apply here and/or for other reports.
* In a meeting with Dan, Julie and Tina we also realized we need to include the newer home with supports etc in the definition of where someone was discharged to, and we may want to base this on Visit_Admit_dttm instead and so consider re-admission to either CC or med. If I understand right, the current definition considers someone who is re-admitted to ED the next day but then spends a week in CC before coming to a medicine bed is not considered a re-admission to medicine. I think EMIPs are excluded in the same way.
}}
* List of individual patients for chart review
* List of individual patients for chart review


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===Exclusion Criteria===
===Exclusion Criteria===
Excluding patients who left against medical advice ([[AMA]]), [[Palliative Service|palliative patients]] in the count of readmission.
Excluding patients who  
* Left the '''earlier''' ward or unit against medical advice ([[Dispo]] = [[AMA]])  
* Arrived on the '''later''' ward as [[Palliative patient]]:
::{{palliative patient}}


Exclusions for readmissions are the following:
===Frequency===
* There is a planned admission like elective surgery
* Left the ward or unit against medical advice ([[Dispo]] = [[AMA]])
* Palliative patients at admission
** The coding for Palliative changed over time.
*** Until Dec 31, 2018 Old coding - 904 and Tmp Project [[Comfort Care]]
*** starting Jan 1, 2019 - ICD10 dx [[Palliative care]] (Z51.5)
* HSC IICU has no readmission


===Frequency===
===SAS definition===
{{Collapsable| always=As per 2025-02-14 email from JM
|full=
&nbsp; <!-- fix formatting for first line -->
    if (0 le diff le 7)  /* within one week included */
        and (
            tolocation in ('Home','HSC Lennox Bell')
            OR  toloctype in ('hospice','PCH','ambulatory care') 
            OR  toregion in ('out-of-WPG','out-of-MB','out-of-CAN')
            /* left the hospital and went home, long-term care facility, outside city and prov */
            or ( lagFromLoctype in ('ER','ambulatory care' ) 
                /*  (came from ER or ambulatory care)
                   
                and ( lagPreInptLocation in ('NA / not applicable',' ') 
                    or lagInptRegion in ('out-of-WPG','out-of-MB','out-of-CAN')
                    )
                    /* was (not an in-patient or in-patient from outside of Winnipeg before that)
             
                or lagFromHospital in ('Children'
                                          ,'Misericordia'
                                          ,'Manitoba Adolescent Treatment Center'
                                          ,'River Ridge Transition Care Environment'
                                          )
                                          /* or Children & Misericordia */
                )                   
                   
            or  lagFromLocation in ('Home' )
            /* next admit from Home */
           
            or  lagFromLoctype in ('PCH')
            /* next admit from nursing home */
        )
    then readm7=1;
    else readm7=0;  /* discharged to hospital ward,ICUs,OR,RR excluded*/
    if AMA=1 and readm7=1 then readm7=0;  /* AMA is excluded to readmission */
    if palliative=1  and readm7=1 then readm7=0;  /*palliative excluded */
    /* EMIP pts moving to another ward is not readmission */
    if Ward='EMIP' and (0 le diff le 7) and lagfromloctype in ('ER') then do;
    readm7=0; end;
    /* Same Visit_Admit_DtTm is not readmission */
    if nextvisit=Visit_Admit_DtTm then do;
    readm7=0; end;
}}


==Definition and Derivation==
==Definition and Derivation==
Number of Med ward readmission within 7 days per 100 discharges to hospital
== Medicine Definition ==
For medicine, a readmission is a patient where
For medicine, a readmission is a patient where
* (current [[Admit DtTm | admit date/time]]) - (most recent [[Dispo DtTm | discharge date/time]] to the hospital) is within 7 days after their most recent discharge date time to the hospital
* (current [[Admit DtTm | admit date/time]]) - (most recent [[Dispo DtTm | discharge date/time]] to the hospital) is within 7 days after their most recent discharge date time to the hospital
* is admitted from outside hospital
* is admitted from outside hospital
 
Readmission is attributed to the site or hospital from which the patient was discharged.
===Numerator===
===Numerator===
Num = Number of ward readmission  within 7 days after being discharged out
Num = Number of ward readmission  within 7 days after being discharged out
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==Data Sources==
==Data Sources==
The following fields from L_Log table - [[Accept_DtTm field]] or [[Arrive DtTm field]], [[Dispo DtTm field]], [[Dispo field]],  the Project [[Comfort Care]] from L_TmpV2 table and diagnosis code [[Palliative Service]] from L_DXs table, ICD10 code Z51.5 [[Palliative care]] from L_ICD10 table are used.
The following fields:
[[Admit DtTm]], [[Dispo DtTm field]], [[Dispo field]],  the Project [[Comfort Care]] from L_TmpV2 table and diagnosis code [[Palliative Service]] from L_DXs table, ICD10 code Z51.5 [[Palliative care]] from L_ICD10 table are used. Julie has confirmed this setup 2022 April 21.


==SAS Program==
==SAS Program==
X:\Julie\SAS_CFE\CFE_macros\medreadm.sas
{{S:\MED\MED_CCMED}}Julie\SAS_CFE\CFE_macros\medreadm.sas


==Report Users==
==Report Users==
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*Medicine Standards Committee - Dr. Elizabeth Salamon  
*Medicine Standards Committee - Dr. Elizabeth Salamon  


[[Category: Data Use]]
== Related articles ==
[[Category: Reporting]]
{{Related Articles}}
[[Category: Statistical Analysis]]
 
[[Category: Multiple Encounter linking]]
[[Category:Data Use]]
[[Category:Reporting]]
[[Category:Statistical Analysis]]
[[Category:Multiple Encounter linking]]