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Definition

Admissions to hospital that could have potentially been prevented through the provision of appropriate non-hospital health services.

Indicator Summary

Numerator

Number of potentially preventable hospitalisations, divided into three groups and total:

  • vaccine-preventable conditions (e.g. tetanus, measles, mumps, rubella)
  • acute conditions (e.g. ear, nose and throat infections, dehydration/gastroenteritis)
  • chronic conditions (e.g. diabetes, asthma, angina, hypertension, congestive heart failure and chronic obstructive pulmonary disease)
  • all potentially preventable hospitalisations
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Denominator
Total population
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Computation

Note that the codes below are ICD-10-AM 7th edition.

Table 22 A: ICD-10-AM codes used for identifying potentially preventable hospitalisations

Category

ICD-10-AM codes

Vaccine-preventable

Influenza and pneumonia

J10, J11, J13, J14, J15.3, J15.4, J15.7, J15.9, J16.8, J18.1, J18.8 in any diagnosis field, excludes cases with additional diagnosis of D57 (sickle-cell disorders) and people under2 months

Other vaccine-preventable conditions

A35, …

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Disaggregation

2008-09, 2009-10 (revised) and 2010–11—Nationally (by three groups and total) by SEIFA Index of Relative Socio-Economic Disadvantage (IRSD) deciles.

2008-09, 2009-10 (revised) and 2010–11—State and territory (by three groups and total), by:

  • Indigenous status
  • remoteness (Australian Standard Geographical Classification Remoteness Structure)
  • SEIFA IRSD quintiles

2007-08, 2008-09, 2009-10, 2010-11 — Nationally, by Indigenous status by remoteness.

Some disaggregation may result in numbers too small for publication. National disaggregation by Indigenous status will be based on data only from jurisdictions for which …

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Calculation rules

Computation Rule
Description

Note that the codes below are ICD-10-AM 7th edition.

Table 22 A: ICD-10-AM codes used for identifying potentially preventable hospitalisations

Category

ICD-10-AM codes

Vaccine-preventable

Influenza and pneumonia

J10, J11, J13, J14, J15.3, J15.4, J15.7, J15.9, J16.8, J18.1, J18.8 in any diagnosis field, excludes cases with additional diagnosis of D57 (sickle-cell disorders) and people under2 months

Other vaccine-preventable conditions

A35, A36, A37, A80, B05, B06, B16.1, B16.9, B18.0, B18.1, B26, G00.0, M01.4 in any diagnosis field

Chronic

Asthma

J45, J46 as principal diagnosis only

Congestive cardiac failure

I50, I11.0, J81 as principal diagnosis only, exclude cases with the following procedure codes: 33172-00, 38300-00, 38303-00, 38306-02, 38306-00, 38353-02, 38353-00, 38350-00, 38368-00, 38256-00, 38350-02, 38358-00, 38358-01, 38358-02, 38368-02, 38654-02, 38456-26, 38456-27, 38368-04, 38358-03, 38654-05, 38456-33, 38456-34, 38270-01, 38456-19, 38456-15, 38456-12, 38456-11, 38456-10, 90203-00, 38456-01, 38470-00, 38475-00, 38480-02, 38480-01, 38480-00, 38488-06, 38488-04, 38489-04, 38488-02, 38489-03, 38487-00, 38489-02, 38488-00, 38489-00, 38490-00, 38493-00, 38497-04, 38497-03, 38497-02, 38497-01, 38497-00, 38500-00, 38503-00, 38505-00, 38362-00, 90203-08, 90203-09, 38456-28, 38612-00, 38615-00, 38653-00, 38700-02, 38700-00, 38739-00, 38742-02, 38742-00, 38745-00, 38751-02, 38751-00, 38757-02, 38757-01, 38757-00, 90204-00, 90205-00, 90219-00, 90224-00

Diabetes complications

E10–E14.9 as principal diagnoses

and E10–E14.9 as additional diagnoses where the principal diagnosis was:

– hypersmolarity (E87.0)

– acidosis (E87.2)

– transient ischaemic attack (G45)

– nerve disorders and neuropathies (G50–G64)

– cataracts and lens disorders (H25–H28)

– retinal disorders (H30–H36)

– glaucoma (H40–H42)

– myocardial infarction (I21–I22)

– other coronary heart diseases (I20, I23–I25)

– heart failure (I50)

– stroke and sequelae (I60–I64, I69.0–I69.4)

– peripheral vascular disease (I70–I74)

– gingivitis and periodontal disease (K05)

– kidney diseases (N00–N29) [including end- stage renal disease (N17–N19)]

– renal dialysis (Z49)

COPD

J20, J41, J42, J43, J44, J47 as principal diagnosis only, J20 only with additional diagnoses of J41, J42, J43, J44, J47

Angina

I20, I24.0, I24.8, I24.9 as principal diagnosis only, exclude cases with procedure codes not in blocks [1820] to [2016]

Iron deficiency anaemia

D50.1, D50.8, D50.9 as principal diagnosis only.

Hypertension

I10, I11.9 as principal diagnosis only, exclude cases with procedure codes according to the list of procedures excluded from the Congestive cardiac failure category above.

Nutritional deficiencies

E40, E41, E42, E43, E55.0, E64.3 as principal diagnosis only.

Rheumatic heart disease

I00 to I09 as principal diagnosis only. (Note: includes acute rheumatic fever)

Acute

Dehydration and gastroenteritis

A09.9, E86, K52.2, K52.8, K52.9 as principal diagnosis only.

Pyelonephritis

N10, N11, N12, N13.6, N39.0 as principal diagnosis only.

Perforated/bleeding ulcer

K25.0, K25.1, K25.2, K25.4, K25.5, K25.6, K26.0, K26.1, K26.2, K26.4, K26.5, K26.6, K27.0, K27.1, K27.2, K27.4, K27.5, K27.6, K28.0, K28.1, K28.2, K28.4, K28.5, K28.6 as principal diagnosis only.

Cellulitis

L03, L04, L08, L88, L98.0, L98.3 as principal diagnosis only, exclude cases with any procedure except those in blocks 1820 to 2016 or if procedure is 30316-02, 30676-00, 30223-02, 30064-00, 34528-02, 39127-00, 90661-00 and this is the only listed procedure

Pelvic inflammatory disease

N70, N73, N74 as principal diagnosis only.

Ear, nose and throat infections

H66, H67, J02, J03, J06, J31.2 as principal diagnosis only.

Dental conditions

K02, K03, K04, K05, K06, K08, K09.8, K09.9, K12, K13 as principal diagnosis only.

Appendicitis with generalised peritonitis

K35.2, K35.3 in any diagnosis field

Convulsions and epilepsy

G40, G41, O15, R56 as principal diagnosis only

Gangrene

R02 in any diagnosis field

Rates directly age-standardised to the 2001 Australian population.

Analysis by state and territory, remoteness and SEIFA Index of Relative Socioeconomic Disadvantage (IRSD) is based on usual residence of person.

Presented as a number per 100,000 population.
Numerators

Number of potentially preventable hospitalisations, divided into three groups and total:

  • vaccine-preventable conditions (e.g. tetanus, measles, mumps, rubella)
  • acute conditions (e.g. ear, nose and throat infections, dehydration/gastroenteritis)
  • chronic conditions (e.g. diabetes, asthma, angina, hypertension, congestive heart failure and chronic obstructive pulmonary disease)
  • all potentially preventable hospitalisations
Denominators
Total population
Disaggregation

2008-09, 2009-10 (revised) and 2010–11—Nationally (by three groups and total) by SEIFA Index of Relative Socio-Economic Disadvantage (IRSD) deciles.

2008-09, 2009-10 (revised) and 2010–11—State and territory (by three groups and total), by:

  • Indigenous status
  • remoteness (Australian Standard Geographical Classification Remoteness Structure)
  • SEIFA IRSD quintiles

2007-08, 2008-09, 2009-10, 2010-11 — Nationally, by Indigenous status by remoteness.

Some disaggregation may result in numbers too small for publication. National disaggregation by Indigenous status will be based on data only from jurisdictions for which the quality of Indigenous identification is considered acceptable.

References

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