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15/09/2017

Tackling the National Readmissions Challenge through QlikView Applications

Readmissions are a challenge for most health economies. Defined as an event of a patient who has been treated and discharged from a hospital and then admitted again to a hospital within England as an emergency within zero to thirty days of the previous discharge, readmissions are linked with both mortality rates and length of stay throughout the NHS.

The NHS Institute for Innovation and Improvement stated that a ‘significant proportion of patients’ are readmitted to hospital within 30 days (3% – 11%). Evidence suggests that reducing readmission rates can reduce the average length of stay, whilst, conversely, reducing average length of stay without addressing readmission rates may have the medium-term impact of increasing average length of stay.

Nationally, nearly half of all readmissions occur within 1 week of discharge, whilst 15% occurred within 1 day of discharge. This equates to a total cost of just under £1.5 billion to NHS acute Trusts – an average of over £9 million per Trust. Factoring in payment by results schemes that penalise Trusts should a readmission be clinically related to the admission may increase this cost further.

Table 1 – England Acute Trust Readmission Data for Selected Specialties – Payment by Results (PbR) Overview

Specialty Number of Total Discharges Number of 30 Days Readmissions Readmission Rate Number of 30 Days Readmissions (PbR) Readmission Rate (PbR) Readmission Cost (PbR)
Accident & Emergency 444,986 78,162 17.6% 60,116 13.5% £64.1million
Thoracic Medicine 238,257 35,554 14.9% 31,801 13.3% £78.4 million
General Medicine 1,636788 233,618 14.3% 199,095 12.2% £382.2 million
Medical Oncology 42,059 5,507 13.1% 3,832 9.1% £6.6 million
Cardiology 496,931 51,335 10.3% 43,730 8.8% £115.7 million
General Surgery 1,037,842 92,336 8.9% 85,416 8.2% £168.7 million
Neurosurgery 65,764 6,402 9.7% 4,416 6.7% £17.6 million
Urology 590,988 39,190 6.6% 36,790 6.2% £49.3 million
Ear, Nose and Throat 273,382 14,426 5.3% 12,806 4.7% £17.8 million
Trauma & Orthopaedics 937,292 44,702 4.8% 39,368 4.2% £143.2 million
Neurology 116,303 5,148 4.4% 4,051 3.5% £9.0 million
Paediatrics 796,010 97,193 12.2% 24,646 3.1% £22.3 million
Opthalmology 564,551 12,686 2.2% 11,908 2.1% £9.2 million
Grand Total 7,241,153 716,259 9.9% 557,975 7.7% £1.084 billion

Given the importance of identifying the source of the problem in readmissions, our Readmissions Application can provide great insight into the root cause of higher risk groups where there is increased occurrence of readmissions by drilling down through a number of variables through to patient level. The ability to look into specialty, diagnosis group, ward or consultant over a customisable period of time can help to identify an area that might need particular attention, thus reducing readmissions and in turn reducing readmission costs.

In the latest version of the app, we have placed a greater emphasis on simplifying our analytics solution. This ensures that nurses, managers, doctors, primary carers and executives can access and monitor the relevant KPIs, thereby proactively reducing patient readmission rates within their organisations. Organisations have reported a reduction in the number of readmissions within 28 days through the use of our app – saving them time, money and resources and ultimately improving the quality for patients.

If you want to find out more about how to reduce your readmission rates, please do not hesitate to contact us.