Trends in Preventable Hospitalizations

Of the 40 million hospitalizations in 2008, 4 million could have potentially been prevented in patients had received appropriate outpatient care, according a report from the Agency for Healthcare Research and Quality (AHRQ).

In the report, Elizabeth Stranges, MS, and Carol Stocks, RN, found that older patients and those living in rural areas are more likely to have preventable hospitalizations.

Other key results from the analyses are as follows:

• The majority of potentially preventable hospital stays were for patients ages 65 and older (2.4 million stays, accounting for 60% of all potentially preventable hospitalizations). Patients aged 45—64 accounted for 1.1 million potentially preventable stays (28%), and patients 18–44 accounted for the remainder (12%).
• Potentially preventable conditions accounted for about 10% of all hospitalizations for both males and females. However, males were more likely than females to be hospitalized for a potentially preventable chronic condition, while males were less likely to be hospitalized for a potentially preventable acute condition.
• Hospital stays paid for by Medicare were over three times more likely to be potentially preventable than were stays paid for by private insurance or Medicaid, and uninsured stays were nearly twice as likely to be potentially preventable as privately insured or Medicaid-covered stays.
• Potentially preventable chronic conditions accounted for 10.1% of Medicare stays, while potentially preventable acute conditions accounted for 6.8%.
• Roughly the same proportion of privately insured and Medicaid covered stays—one out of 20—were potentially preventable. Chronic conditions accounted for slightly more preventable Medicaid stays (3.8%) than privately insured stays (3.3%) while acute conditions accounted for slightly fewer Medicaid stays (1.6%) than privately insured stays (2.1%).
• Hospital stays for patients living in the poorest communities were more likely to be potentially preventable (11.7%) than were stays for patients living in the wealthiest communities (8.1%). In fact, across the four community income quartiles, as community income level increased, the share of potentially preventable hospital stays decreased.
• Potentially preventable stays for chronic conditions accounted for 7.5% of the hospitalizations among patients living in the poorest communities. In contrast, stays for these conditions accounted for only 4.8% of the hospitalizations among patients living in the wealthiest communities. Potentially preventable stays for acute conditions comprised 4.2% of hospitalizations among patients living in the poorest communities, a slightly larger portion than among patients living in the wealthiest communities.
• Potentially preventable conditions accounted for 9.2% of stays in urban hospitals but 15.9% of stays in rural hospitals. Potentially preventable stays for acute conditions made up 3.4% of all urban hospital stays and 7.0% of all rural hospital stays while potentially preventable stays for chronic conditions made up 5.8% of urban hospital stays and 8.9% of rural hospital stays.
• Hospitalizations in the West were less likely to be potentially preventable than were those in Northeast, Midwest, and South. In the West, a total of 8.1% of all hospitalizations were potentially preventable, while in the Northeast, Midwest, and South, 10% of more of all hospital stays were potentially preventable.

To access the report—Potentially Preventable Hospitalizations for Acute and Chronic Conditions, 2008—click here.

Do you think that enough is being done to prevent hospitalizations for chronic conditions? What possible impact will health care reform have on these trends?