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Number of discharges for ambulatory care-sensitive conditions per 1,000 Medicare beneficiaries

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Preventable Hospitalizations: Vermont

Vermont Preventable Hospitalizations (2001-2015) see more
  • Number of discharges for ambulatory care-sensitive conditions per 1,000 Medicare beneficiaries

Preventable Hospitalizations

United States Preventable Hospitalizations (2001-2015) see more
  • Number of discharges for ambulatory care-sensitive conditions per 1,000 Medicare beneficiaries
Ranking Value State
1 24.4 Hawaii
2 31.1 Utah
3 33.2 Colorado
4 33.3 Idaho
5 34.5 Oregon
6 35.6 Washington
7 40.1 Alaska
7 40.1 Arizona
9 40.7 California
10 41.2 Minnesota
11 43.2 Vermont
12 43.7 Montana
13 45.5 New Mexico
14 45.7 Nevada
15 46.3 New Hampshire
16 47.9 Wisconsin
16 47.9 Wyoming
18 49 Virginia
19 49.7 Maryland
20 49.8 South Carolina
21 50.1 Connecticut
22 50.5 Maine
23 50.6 North Dakota
24 50.9 Iowa
25 51.1 North Carolina
26 51.3 Nebraska
27 51.8 South Dakota
28 53.3 Delaware
28 53.3 New York
30 54 Rhode Island
31 54.5 Kansas
32 55.1 Georgia
33 55.3 Florida
34 55.5 New Jersey
35 56.2 Massachusetts
36 57.1 Pennsylvania
37 57.6 Texas
38 59 Missouri
39 59.1 Michigan
40 59.4 Illinois
41 62.6 Oklahoma
42 63.2 Indiana
43 64.8 Tennessee
44 64.9 Ohio
45 65.4 Alabama
46 65.9 Arkansas
47 73.3 Louisiana
48 73.6 Mississippi
49 81.2 West Virginia
50 85.1 Kentucky

Highlights

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Core Measure Impact
Preventable Hospitalizations
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Preventable Hospitalizations
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Preventable Hospitalizations
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Overview

Preventable Hospitalizations is a measure of the discharge rate of Medicare beneficiaries aged 65 to 99 years with full Part A entitlement and no health maintenance organization (HMO) enrollment from hospitals for ambulatory care-sensitive conditions. Ambulatory care–sensitive conditions are optimally treated with outpatient care, potentially preventing the need for hospitalization or conditions in 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. The 2015 ranks are based on 2013 data from The Dartmouth Atlas of Health Care.

The rate of preventable hospitalizations ranges from a low of 24.4 discharges per 1,000 Medicare beneficiaries in Hawaii to over 80 discharges per 1,000 Medicare beneficiaries in Kentucky and West Virginia. The national average is 57.6 discharges per 1,000 Medicare beneficiaries, down from 62.9 discharges last year.  The decline in preventable hospitalizations has been relatively steady over the last 14 years from a rate of 82.5 discharges per 1,000 Medicare enrollees in the 2001 Edition.  Part of the decline in the recent year may be due to a new policy of redacting cases due to substance abuse including alcohol. (http://www.resdac.org/resconnect/articles/203)

Public Health Impact

The number of preventable hospitalizations is an indicator of a health care system's efficiency.[1] Analyzing causes of preventable hospitalizations and disparities in hospital admission rates identifies ways to cut costs through reducing these hospitalizations overall and in specific populations.[2]

Conditions that can usually be managed outside a hospital include certain hospitalizations for diabetes, chronic obstructive pulmonary disorder, and asthma.[3] These hospitalizations reflect how a population uses outpatient health care as well as the quality of the ambulatory health care received. Preventable hospitalizations often occur because of failure to manage conditions early in an outpatient setting.[4] For older adults, improved continuity of care is associated with fewer preventable hospitalizations.[5]

Preventable hospitalizations are more common among the uninsured, which can lead to large unpaid medical bills.[6] Preventable hospitalizations also financially burden the health sector because they can typically be avoided with less costly interventions. In 2006, $30.8 billion of hospital costs was attributed to preventable hospitalizations.[7]

While there is much to learn about preventing ambulatory care sensitive hospitalizations, physician-driven strategies include closer monitoring of high-risk patients, access to ambulatory care services after hours, and improving access to preventive care services.[8]

Increasing the proportion of persons who have a specific source of ongoing care and increasing the number of practicing primary care providers are 2 objectives under “Access to Health Services” for Healthy People 2020.



[1] CDC health disparities and inequalities report—United States, 2013. MMWR Supplement 2013;62(3).

[2] CDC health disparities and inequalities report—United States, 2013. MMWR Supplement 2013;62(3).

[3] Agency for Healthcare Research and Quality, US Department of Human Services. Ambulatory care sensitive conditions. National Quality Measures Clearinghouse. http://www.qualitymeasures.ahrq.gov/content.aspx?id=47604. Accessed June 18, 2015.

[4] Billings J. Recent findings on preventable hospitalizations. Health Aff. 1996;15(3):239.

[5] Nyweide DJ, Anthony DL, Bynum JPW, et al. Continuity of care and the risk of preventable hospitalization in older adults. JAMA Intern Med. 2013;173(20):1879-1885.

[6] Weissman JS. Rates of avoidable hospitalization by insurance status in Massachusetts and Maryland. JAMA. 1992;268(17):2388.

[7] Jiang HJ, Russo CA, Barrett MS. Nationwide Frequency and Costs of Potentially Preventable Hospitalizations, 2006. Statistical Brief #72. Healthcare Cost and Utilization Project (HCUP). February 2011. Agency for Healthcare Research and Quality, Rockville, MD. http://www.hcup-us.ahrq.gov/reports/statbriefs/sb72.jsp. Accessed November 5, 2015.

[8] Freund T, Campbell SM, Geissler S, et al. Strategies for reducing potentially avoidable hospitalizations for ambulatory care-sensitive conditions. Ann Fam Med. 11(4):363-370.