Hospital readmission rates are up to 40 per cent higher than previously believed, according to new data, raising questions about whether patients are being discharged too early.
Subscribe now for unlimited access.
$0/
(min cost $0)
or signup to continue reading
The NSW Auditor-General warned in April that the unplanned readmission rate of 6.8 per cent was too high and climbing, despite various attempts to reduce it
But the real number of people who limp back into acute care is even larger, because the Auditor-General's data did not capture people who returned to a different hospital than where they were originally treated, nor those who returned to acute care from rehabilitation within the same hospital.
An analysis by the NSW Bureau of Health Information on hospital readmissions between 2009 and 2012, released on Wednesday, has captured 18 to 40 per cent more people returning to acute care than earlier reports.
The report examined a selection of clinical conditions and surgical procedures, and took into account the complexity of each hospital's caseload.
The bureau's chief executive, Jean-Frederic Levesque, said although some readmissions were unavoidable, others indicated that patient care could be improved or systems made more efficient.
"It's really for the hospitals to look at the numbers and identify whether the care under their control can be improved," Dr Levesque said.
Most hospitals had no more readmissions than would normally be expected, but certain hospitals had higher than expected rates for individual conditions.
Among them, Nepean and Auburn hospitals had higher than expected readmission rates for three conditions while Westmead and Wagga Wagga had higher rates for two conditions.
Hospitals have sought new ways to liberate beds as their patient population has climbed, reaching 1.8 million admissions in 2014.
Strategies include introducing short-stay units (where emergency patients are sent rather than admitting them into the wards), more same-day surgery and improving patient flow through the hospital.
But unplanned readmissions have drifted further away from the NSW target of 5.5 per cent.
Flinders University epidemiologist David Ben-Tovim said people were concerned about readmissions because they could indicate patients were not receiving high quality of care, or that the hospital was not communicating with family practitioners about their post-operative care.
"Or is someone going around saying, 'We've got 78 people stuck in the emergency department and we've got to get people out'?" Professor Ben-Tovim said.
"Are people being discharged primarily because of the log jam at the front door?"
But Westmead and Auburn hospitals' general manager Andrew Newton said problems with readmissions had improved, because the hospitals were better at sharing information with GPs before and after discharge.
They also interrogated the readmissions data they received from NSW Health to ensure patients were not being discharged too early.
"We don't believe that we have many patients readmitted because we've tried to reduce the length of stay," Mr Newton said.
"We've actually put significant investment into the community to prevent that happening."
