Readmissions higher than previously thought at NSW hospitals

Date: Jun 30, 2015

New analysis of hospital readmission data has revealed more people have to return for treatment following acute care than was previously reported.

The NSW Bureau of Health Information (BHI) introduced different measures to record readmissions after criticism of traditional methods. For example, people who returned to a different hospital than the one at which they first received care were not counted under the old system.

Readmissions may indicate substandard care, which could lead to medical negligence claims if patients feel their medical practitioner breached their professional responsibilities. BHI Chief Executive Dr Jean-Frederic Levesque said not all instances of individuals returning to hospital are avoidable.

“However, some represent a poor outcome for patients. Returning to hospital can be disruptive and stressful, and high rates can point to underlying issues such as complications or inappropriate post-discharge care,” he stated.

The BHI report examined how many patients returned to care within 30 days of treatment for five conditions: hip fracture surgery, myocardial infarction, pneumonia, congestive heart failure and ischaemic stroke. Two elective surgeries – total knee or total hip replacements – were also researched for readmissions within 60 days.

Which hospitals fell short?

Although a large proportion of NSW hospitals had normal readmissions rates, several facilities had higher patient returns than previously thought.

Nepean Hospital exceeded expected levels for three of the studied conditions and both elective surgeries. Wagga Wagga’s statistics were higher on two conditions and both surgeries, while Auburn failed on three conditions.

Pneumonia was the illness that caused the most problems, with seven hospitals judged to have higher than expected readmissions. The disease was also the most common of the acute conditions, with all 78 hospitals having more than 49 cases over the three-year period between 2009 and 2012.

However, while some results were disappointing, BHI said 73 per cent of hospitals did not exceed the readmission ratio for any of the illnesses or surgeries. Nevertheless, 21 facilities appeared to fall short of expectations.

Flinders University epidemiologist David Ben-Tovim told the Sydney Morning Herald that some people fear the figures show people are not receiving proper care.

“Is someone going around saying, ‘We’ve got 78 people stuck in the emergency department and we’ve got to get people out’?” he asked. “Are people being discharged primarily because of the log jam at the front door?”

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