Risk-adjusted Readmission Ratio for patients with an acute inpatient hospital stay for: Acute Myocardial Infarction (age>= 45 years); Cardiac conditions (excluding AMI, CHF) (age>= 40 years); Congestive heart failure (age>=45 years); Chronic obstructive pulmonary disease; Pneumonia (all ages); Diabetes (all ages); Stroke (age>=45 years); Gastrointestinal disease (all ages) who after discharge have a subsequent non-elective readmission within 30 days

The sum of all readmissions for all index cases in the reporting period. The hospitalisation readmission is counted if: the readmission date is within 30 days of the index case discharge; the DAD field "admission category" is urgent/emergent; the admission is not coded as an acute transfer by receiving hospital (unless the readmission was coded as a transfer from the same hospital)

Patient with: Acute Myocardial Infarction (age 45+); Cardiac conditions other than heart attack (age 40+); Congestive heart failure (age 45+); Chronic obstructive pulmonary disease (age 45+); Pneumonia; Diabetes; Stroke (age 45+); Gastrointestinal disease

Records with missing valid data on discharge/admission date, Ontario health card number, age or gender; 2. Index cases coded as transfers to another acute inpatient hospital, deaths, or sign-outs; 3. Exclude cases with Discharge disposition = '07' (death). For FY 2018 and onwards, exclude cases with discharge disposition = '72' (died in facility), '73' (medical assistance in dying (MAID)), '74' (suicide in facility)

Numerator: Expected Readmissions: To calculate the predicted probability of non-elective readmission to any Ontario acute care hospital for patients discharged with the specified HIGs, a logistic regression model is fitted with HIG, age, gender, prior hospitalisations (within 1, 2 and 3 months), quarterly seasonality (calendar year) and the Charlson co-morbidity adjustment index score as independent variables. Coefficients derived from the logistic model are used to calculate the probability of readmission for each patient. The expected number of readmissions for a hospital/LHIN is the sum of the patient probabilities for all the index admissions in that hospital/LHIN.

Discharge Abstract Database (DAD) captures administrative, clinical and demographic information on hospital discharges (including deaths, sign-outs and transfers). Data is received directly from acute care facilities or from their respective health/regional authority or ministry/department of health.

www.health.gov.on.ca/en/pro/programs/ris/docs/readmission30daysselectedhigsen.pdf