Measure 4.1

Objective area
Outcome area
Coordinated care
Proportion of people with life-limiting illnesses with a potentially preventable hospitalisation in their last 3 months of life.
People with life-limiting illnesses who died within the reference year. 
Number of people with life-limiting illnesses with at least one potentially preventable hospitalisation in a public hospital in the last 3 months of life (0-90 days). Namely, an admission within the reference year for any of the following three condition groups:
  • (a) acute conditions (cellulitis, convulsions and epilepsy, dental conditions, ENT infections, gangrene, pelvic inflammatory disease, perforated/ bleeding ulcer, pneumonia, UTI)
  • (b) chronic conditions (angina, asthma, bronchiectasis, congestive cardiac failure, COPD, diabetes complications, hypertension, iron deficiency anaemia, nutritional deficiencies, rheumatic heart disease)
  • (c) vaccine-preventable conditions (pneumonia, influenza, other).
Number of people with life-limiting illnesses who died within the reference year. 
(Numerator ÷ Denominator) x 100
State/Territory, Age, Sex, Socioeconomic area, Remoteness area, Hospitalisation condition group, Cause of death, Length of stay.  See Data sources for more information on these items.
AIHW National Integrated Health Service Information (NIHSI) linked data asset.
People with life-limiting illnesses – all people who died in the reference year and had an underlying cause of death amenable to palliative care based on Murtagh et al. (2013) as shown in Table 4.1.2.
Table 4.1.2: Causes of death amenable to palliative care based on Murtagh et al. (2013)
Cause of deathICD-10 codes
Neoplasm (excludes benign neoplasms)C00-C97
Heart diseaseI00-I52
Cerebrovascular diseaseI60-I69
Renal diseaseN17, N18, N28
Liver diseaseK70-K77
Respiratory diseaseJ06-J18, J20-J22, J40-J47, J96
Neurodegenerative diseaseG10, G20, G35, G122, G903, G231
Alzheimer’s diseaseF01, F03

Potentially preventable hospitalisation– an admission to hospital for a condition where the hospitalisation could have potentially been prevented through the provision of appropriate individualised preventative health interventions and early disease management usually delivered in primary care and community-based care settings including: 
CategoryICD-10Additional requirements
CellulitisL02, L03, L04, L08, L88, L98.0, L98.3As principal diagnosis, AND if the record has:
  1. No procedures whatever OR
  2. All procedures for the record are within the blocks [1820] to [2016] OR
  3. The record has only one procedure and that procedure is one of 30216-00[1604], 30216-01[1604], 30216-02[1604], 30676-00[1659], 30676-02[1659], 30223-01[1606], 30223-02[1606], 30064-00[1605], 90660-00[1602], 90661-00[1608], 96230-00[1659].
Convulsions and epilepsy
G40, G41, R56
As principal diagnosis.
Dental conditions
K02 – K06, K08, K09.8, K09.9, K12, K13, K14.0
As principal diagnosis.
Ear, nose, and throat infections
H66, J02, J03, J06, J31.2
As principal diagnosis.
GangreneR02In any diagnosis.
I70.24, E09.52
As principal diagnosis.
Pelvic inflammatory diseaseN70, N73, N74
As principal diagnosis.
Perforated or 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.
Pneumonia (not vaccine-preventable)
J15.3, J15.4, J15.7, J16.0
In any diagnosis. Exclude people under 2 months.
Urinary tract infectionsN10, N11, N12, N13.6, N15.1, N15.9, N28.9, N39.0, N39.9
As principal diagnosis.
AnginaI20, I24.0, I24.8, I24.9
As principal diagnosis. Exclude cases according to the list of procedures excluded from the Congestive cardiac failure category.
J45, J46
As principal diagnosis. Exclude children aged less than 4 years.
As principal diagnosis.
J20As principal diagnosis. Only with additional diagnosis of J47.
Congestive cardiac failure

I50, I11.0, J81
As principal diagnosis. Exclude cases with the following cardiac procedure codes: Blocks [572], [600]–[606], [608]–[650], [653]–[657], [660]–[664], [666], [669]–[682], [684]–[691], [693], [705]–[707], [717] and codes 33172-00[715], 33827-01[733], 34800-00[726], 35412-00[11], 38721-01[733], 90217-02[734], 90215-02[732].
Chronic obstructive pulmonary disease (COPD)
As principal diagnosis. Only with additional diagnoses of J41, J42, J43, J44.
J41, J42, J43, J44
As principal diagnosis.
Diabetes complicationsE10.0–E10.9, E11.0–E11.9, E13.0–E13.9, E14.0–E14.9As principal diagnosis.
I10, I11.9
As principal diagnosis. Exclude cases with procedure codes according to the list of procedures excluded from the Congestive cardiac failure category.
Iron deficiency anaemia
D50.1, D50.8, D50.9
As principal diagnosis.
Nutritional deficiencies
E40, E41, E42, E43, E55.0
As principal diagnosis.
Rheumatic heart diseasesI00, I01, I02, I05, I06, I07, I08, I09
As principal diagnosis.
Vaccine-preventable conditions
Other vaccine-preventable conditions including but not limited to measles, rubella, hepatitis B, diptheria, etc. A08.0, A35, A36, A37, A80, B01, B05, B06, B16.1, B16.9, B18.0, B18.1, B26, G00.0In any diagnosis.
Pneumonia and influenza (vaccine-preventable)
J10, J11, J13, J14
In any diagnosis. Exclude people under 2 months.
  1. There are many factors that can contribute to a lack of individualised preventative health interventions that may lead to a potentially preventable hospitalisation. This can include patient choice, a lack of at-home support, and/or barriers to accessing primary and community care such as geographical remoteness, affordability, and/or opening hours. As such, a certain level of potentially preventable hospitalisations will likely always be present. Reducing their occurrence should be an aim of improving the quality of palliative care in Australia. 
  2. There is currently no complete national data on potentially preventable hospitalisations for people with life-limiting illnesses. The NIHSI linked data asset is the only available national data that identifies inpatient procedures and cause-specific outcomes. However, this data collection does not present a complete picture of health service use, as it excludes hospital data from Western Australia and the Northern Territory, and all private hospitals nationally for this analysis, for the reference period. It omits services received by patients in specialised palliative care units in private hospitals/facilities. See Data sources for more information.