Unplanned hospital readmissions for patients within 28 days for selected surgical procedures (per 1000 separations)

Outcome one // Effectiveness KPI

Rationale

Unplanned hospital readmissions may reflect less than optimal patient management and ineffective care pre-discharge, post-discharge and/or during the transition between acute and community-based care. These readmissions necessitate patients spending additional periods of time in hospital as well as utilising additional hospital resources.

Readmission reduction is a common focus of health systems worldwide as they seek to improve the quality and efficiency of healthcare delivery, in the face of rising healthcare costs and increasing prevalence of chronic disease.

Readmission rate is considered a global performance measure, as it potentially points to deficiencies in the functioning of the overall healthcare system. Along with providing appropriate interventions, good discharge planning can help decrease the likelihood of unplanned hospital readmissions by providing patients with the care instructions they need after a hospital stay and helping patients recognise symptoms that may require medical attention.

The 7 surgeries selected for this indicator are based on those in the current National Healthcare Agreement Unplanned Readmission performance indicator (NHA PI 23). 

Note: This indicator is reported by calendar year. Some indicators are reported by calendar year to allow for delays associated with the clinical coding of medical records, data quality checking, data linkage processing, and the setting of targets in accordance with the Government Budget Statement.

Target

The 2025 targets for unplanned readmissions for each procedure (per 1,000 separations) are outlined below. Improved or maintained performance is demonstrated by a result below or equal to target.

ProcedureTarget
(a) knee replacement ≤ 18.8
(b) hip replacement ≤ 18.3
(c) tonsillectomy & adenoidectomy≤ 79.2
(d) hysterectomy  ≤ 44.1
(e) prostatectomy  ≤ 37.5
(f) cataract surgery  ≤ 2.2
(g) appendicectomy≤ 27.8

Results

Click the drop-down arrow to see different KPI categories

Year Target Actual
Years 2025 Target 18.8 Actual 8.7 Chart
Years 2024 Target Actual 14.4 Chart
Years 2023 Target Actual 14.3 Chart
Years 2022 Target Actual 10.4 Chart
Year Target Actual
Years 2025 Target 18.3 Actual 10.5 Chart
Years 2024 Target Actual 7.9 Chart
Years 2023 Target Actual 16.4 Chart
Years 2022 Target Actual 11.1 Chart
Year Target Actual
Years 2025 Target 79.2 Actual 128.1 Chart
Years 2024 Target Actual 147.1 Chart
Years 2023 Target Actual 58.8 Chart
Years 2022 Target Actual 84.7 Chart
Year Target Actual
Years 2025 Target 44.1 Actual 36.1 Chart
Years 2024 Target Actual 31.3 Chart
Years 2023 Target Actual 47.9 Chart
Years 2022 Target Actual 25.9 Chart
Year Target Actual
Years 2025 Target 37.5 Actual 4.5 Chart
Years 2024 Target Actual 42.6 Chart
Years 2023 Target Actual 69.4 Chart
Years 2022 Target Actual 54.5 Chart
Year Target Actual
Years 2025 Target 2.2 Actual 1.9 Chart
Years 2024 Target Actual 1.5 Chart
Years 2023 Target Actual 2.6 Chart
Years 2022 Target Actual 2.3 Chart
Year Target Actual
Years 2025 Target 27.8 Actual 16.2 Chart
Years 2024 Target Actual 26.0 Chart
Years 2023 Target Actual 22.3 Chart
Years 2022 Target Actual 25.8 Chart

Commentary

EMHS strives to provide safe, high-quality care to its patients at all times. In 2025 improved performance can be seen across the majority of indicators relating to hospital readmission. EMHS continues to perform case reviews to drive clinical improvement across these cohorts. These reviews can identify variations in care and outcomes, fostering system-wide learning and service improvement. 

In 2025 unplanned readmissions following tonsillectomy and adenoidectomy exceeded target. These results are based on a small number of cases where individual case reviews noted a high degree of patient complexity contributing to the need for readmission, as well as some opportunities for quality improvement to streamline care delivery including standardised delivery of patient information, ensuring consistent discharge advice and optimising pain management protocols. 

EMHS will continue to monitor performance of these indicators.

Period: 2022 to 2025 calendar years
Contributing sites: Armadale Hospital, Bentley Hospital, Kalamunda Hospital, Royal Perth Hospital, St John of God Midland Public Hospital (public patients) 
Data source: Hospital Morbidity Data Collection (HMDC); WA Data Linkage System