Implications of different scenarios for selecting case notes for readmitted patients in terms of the proportion of 28 day readmissions selected and the sensitivity and positive predictive value (PPV) associated with detecting a direct indicator of harm occurring within 28 days
| Scenario | A | B | C | D | E | F |
| All patients readmitted within 28 days | All patients readmitted within 7 days | 7 day readmissions: only primary diagnoses associated with potential harm | 7 day readmissions: primary diagnoses associated with potential harm or other reported direct indicators of harm | 7 day readmissions: primary diagnoses associated with potential harm if length of readmission spell>three days | 7 day readmissions: primary diagnoses associated with potential harm if length of readmission spell>three days, or other reported direct indicators of harm regardless of length of stay | |
| Acute myocardial infarction | ||||||
| % selected (n)* | 100 (8149) | 50 (4072) | 25 (2071) | 28 (2313) | 13 (1084) | 19 (1544) |
| Sensitivity† | 100% | 51% | 36% | 51% | 24% | 51% |
| PPV‡ | 21% | 21% | 30% | 37% | 37% | 56% |
| Urgent bowel surgery | ||||||
| % selected (n)* | 100 (445) | 45 (202) | 38 (169) | 41 (181) | 18 (81) | 32 (141) |
| Sensitivity | 100% | 50% | 44% | 50% | 22% | 50% |
| PPV | 49% | 53% | 57% | 60% | 59% | 77% |
| Elective bowel surgery | ||||||
| % selected (n)* | 100 (2057) | 53 (1086) | 50 (1019) | 50 (1038) | 26 (533) | 41 (849) |
| Sensitivity | 100% | 58% | 57% | 58% | 32% | 58% |
| PPV | 59% | 65% | 67% | 68% | 73% | 83% |
| Hip replacement | ||||||
| % selected (n)* | 100 (2776) | 48 (1344) | 48 (1325) | 48 (1330) | 15 (420) | 29 (812) |
| Sensitivity | 100% | 48% | 48% | 48% | 20% | 48% |
| PPV | 50% | 49% | 50% | 50% | 65% | 82% |
*Proportions are of all readmissions within 28 days.
†Proportion of direct indicators of harm occurring in readmissions within 28 days.
‡Proportion of selected cases that have a direct indicator of harm.
Hospital Episode Statistics data ©2017, reused with the permission of the Health & Social Care Information Centre. All rights reserved.