PHC4 | Potentially Preventable Hospitalizations in Pennsylvania 2010

Potentially Preventable Hospitalizations in Pennsylvania 2010 - News Release

Contact: Gary Tuma, Communications Director
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NEW PHC4 REPORT SHOWS DECLINING RATE OF POTENTIALLY PREVENTABLE HOSPITALIZATIONS IN PENNSYLVANIA

Harrisburg, PA - June 7, 2012 - Approximately one of every eight adult inpatient stays in Pennsylvania general acute care hospitals in 2010 were potentially preventable, but the rate of such hospitalizations has declined over the past decade, according to a new study released today by the Pennsylvania Health Care Cost Containment Council (PHC4).

“The good news in this report is that rates of preventable hospitalizations are on the decline here in PA, due to efforts by employers, fund and plan administrators, health care providers and policy makers to improve patient outcomes and restrain costs.” said Joe Martin, Executive Director of PHC4. “Many preventable hospitalizations involve chronic disease, which affects nearly one out of every two American adults, underscoring why these efforts are important and should continue.”

The PHC4 report examined 12 conditions and found that during the previous decade, the rate of potentially preventable hospitalizations in the state dropped from 231 per 10,000 residents in 2001 to 186.9 per 10,000 residents in 2010. For chronic conditions, the rate fell from 148.1 to 118.5 per 10,000 residents, and for acute conditions, from 83 to 68.4 per 10,000 residents.

“Preventive care can reduce unnecessary hospital visits,” Martin noted. “Every hospital stay avoided through appropriate outpatient care and patient education is generally better for the patient and more cost-effective.”

Potentially preventable hospitalizations are identified through a set of indicators developed by the US Department of Health and Human Services Agency for Healthcare Research and Quality. Using the condition and diagnosis codes under which patients are admitted, the indicators point to hospitalizations that were potentially avoidable with timely and effective outpatient care or disease management.

The word “potentially” is important when analyzing the data, because not all hospitalizations included under that criteria may be preventable. Yet, identifying conditions with higher rates provides actionable information by highlighting areas where early detection, timely care, and patient education might lead to improved patient outcomes and decreased costs.

Overall, 185,190 of the approximately 1.5 million inpatient stays in 2010, or about 12.4 percent, fell into the potentially preventable classification. The three conditions with the highest percent of such hospitalizations were heart failure at 24.8 percent, COPD or asthma in older adults, at 21.1 percent, and bacterial pneumonia at 17.4 percent.

Among the other key findings in the PHC4 report:

Of the adult residents with potentially preventable hospitalizations, 43 percent were between the ages of 65 and 84.
The average length of stay for a patient with a potentially preventable hospitalization was 4.7 days, for a total of 868,564 patient-days in 2010.
Compared to other parts of the state, the 10-county region in southeastern Pennsylvania had the highest rate of potentially preventable hospitalizations at 206.7 per 10,000 residents (adjusted for age and gender).
Medicare fee-for-service (FFS) paid for 41.8 percent of potentially preventable hospitalizations in the state in 2010, at a cost of $480 million. Medicaid FFS paid for 3.4 percent, at a cost of $41 million.

PHC4 is an independent state agency charged with collecting, analyzing and reporting information that can be used to improve the quality and restrain the cost of health care in Pennsylvania. Copies of the free report can be downloaded from PHC4’s website at http://www.phc4.org.