Preventable Hospitalizations is a measure of the discharge rate of Medicare enrollees age 65-99 with full Part A entitlement and no HMO enrollment from hospitals for ambulatory care-sensitive conditions. Ambulatory care–sensitive conditions are those “for which good outpatient care can potentially prevent the need for hospitalization, or for which early intervention can prevent complications or more severe disease^[1]." These conditions are based on ICD-9-CM diagnosis codes and include: convulsions, chronic obstructive pulmonary disease (COPD), bacterial pneumonia, asthma, congestive heart failure (CHF), hypertension, angina, cellulitis, diabetes, gastroenteritis, kidney/urinary infection and dehydration. Ranks are based on the most recently available data from the Dartmouth Atlas of Health Care.  

 

Preventable hospitalizations reflect how efficiently a population uses the various healthcare delivery options for necessary care. Hospital care is expensive and makes up the largest component of health care spending in the U.S., totaling over $750 billion^[2]. Preventable hospitalizations often occur as a result of a failure to treat conditions early in an outpatient setting due to limited availability.^[3] These discharges are also highly correlated with general admissions and reflect the tendency for a population to overuse the hospital setting as a site for care. Preventable hospitalizations place a financial burden on heath care systems as they could have been avoided with earlier less costly interventions. Preventable hospitalizations are more common in those that are uninsured, which often leads to large unpaid medical bills^[4].