7-day follow up

The 7-day follow up (also known as acute inpatient post-discharge community care) indicator data dashboards measure the percentage of acute inpatient discharges that are followed up in the community setting within the 7 days immediately following discharge from an acute inpatient stay.

Why

Literature indicates the time following discharge from inpatient mental health services can be a vulnerable period for some people. Commonly studied issues associated with the transition from inpatient to community care include early readmission and suicide.
Evidence identifies factors that increase people’s likelihood of early readmission, such as having no plans to be followed up after discharge, and insufficient or a lack of comprehensive discharge planning (Callaly et al., 2011; Durbin et al., 2007; Steffen et al., 2009).

Early readmission indicates that people may not have received adequate support from inpatient services; continue to experience high levels of distress; are underprepared for community living; have limited community or whānau support; or experience challenges in accessing community or culturally relevant services (Donisi et al., 2016; Durbin et al., 2007)

The literature highlights a concerning proportion of people who die by suicide within the first week or month following their discharge from inpatient mental health services. In Aotearoa New Zealand, of the 476 people who died by suicide in 2015, 201 people (42 percent) had contact with specialist mental health services the year prior. Of all tāngata whai ora who were in contact with mental health services in the year prior to dying by suicide between 2001 and 2015, 171 people (nearly 7 percent) died within 1 week of discharge (Manatū Hauora Ministry of Health, 2019).

Click here to read more evidence about this indicator.

Populations

7-day follow up indicator data dashboards are built using criteria specific to adult populations (20-64 years), but also provides age filters for child and youth (0-19 years) and older people (65 and over), where this data is reported by services into PRIMHD. Click here to learn more about PRIMHD.

All KPI Programme indicators provide demographic information by age, gender and ethnicity.

Data available through July 2023, sourced from the 27 September 2023 refresh of the PRIMHD DataMart.

Please note:

  • Waikato division has low volumes of contact since Jan 2022, very low to no contacts since July 2022, very low bednights since Nov 2022
  • South Canterbury division has low volumes since July 2022

 

If you have any improvement ideas or feedback please email us at mhakpi.health.nz

Data dashboards

National summary

This report provides a national overview of 7-day follow-up rate within a single financial quarter. It includes changes in national 7-day follow-up rate through time, as well as the follow-up rates for each Te Whatu Ora division compared against the national average.

Within individual divisions, the 7-day follow-up rate can be compared against either the previous quarter or the same quarter in the previous year.

The entire report can be filtered by financial quarter and team target population, as well as key demographics: age, gender and prioritised ethnicity.

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Te Whatu Ora division summary

This report provides individual Te Whatu Ora division summaries, by either financial year or quarter. 7-day follow-up rates are split by age, gender and prioritised ethnicity, and raw data is provided for crosscheck in your local system.

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MOH quarterly reporting (legacy)

This report provides numbers for the legacy DHB performance measure, Improving mental wellbeing MH07: Improving mental health services by improving inpatient post discharge follow-up rates, in a format that was designed to be easily copied into the MOH reporting template. Raw data is provided for crosscheck in your local system. Although this is no longer a division reporting requirement, the report remains active and up-to-date for comparison and trend evaluation.

Summary tables allow comparison between divisions for total population or ethnicity splits, and bar charts show each DHB tracking against the national average.

Date selections are fixed to the official MOH periods for this measure, a rolling 12-month period reported 3 months in arrears.

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Heat map comparison matrices

This report provides heat map matrices that compare 7-day follow-up rate per Te Whatu Ora division, split by either age, ethnicity or gender. To account for the small sample sizes encountered when splitting data into more granular groups, the user can specify thresholds to highlight only intersections with a sufficient number of referrals and high follow-up rate; for example, any age group at a division where at least 50 acute inpatient referrals were discharged and the 7-day follow-up rate was over 90%. This makes it easy to find stellar performance to investigate.

An additional suite of heat map matrices compare the change in 7-day follow-up rate since the previous year, also split by age, ethnicity or gender. Here, the user can highlight intersections where the magnitude of change exceeds a specified threshold; for example, any ethnicity group at a division where there were at least 35 referrals both last year and this year, and where the 7-day follow-up rate has changed by at least 10% since last year. This makes it easy to find areas where performance has been improving or deteriorating, for discussion or further exploration.

The entire report can be filtered by financial year and target team population.

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Explore trees

This report is shared with 28-day readmission.

Explore trees allow you to drill down through the 7-day follow-up data in any order you like, exploring and comparing different cohorts and time periods. This report includes both a simple and advanced trees, as well as several examples with explanation and discussion. This report also incorporates 28-day readmission data, so you can switch between the KPI rates or explore counts of referrals both followed up and readmitted.

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Ask me anything

This report is shared with 28-day readmission.

This is a natural language processor – type in a question or something you want to see, and the data will answer.

Both the 7-day follow-up and 28-day readmission datasets are available to this tool, so you can explore the relationships between these two acute inpatient KPIs. Every question you ask helps it to learn and if you have time, you can leave feedback about how it answers each of your individual questions.

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