America's Health Rankings, United Health Foundation Logo

Recommended Hospital Care

Receiving appropriate hospital care for heart attack, heart failure, pneumonia, and surgical procedures denotes high quality and generates cost savings. Hospitals with low complication rates tend to spend less per episode than those with high complication rates, indicating that foregoing proper care can be more costly. The conditions assessed in this measure are part of the Centers for Medicare & Medicaid Services quality initiative and were chosen for their validity and general acceptance as markers of quality. Despite making up only 14% of the population, seniors account for 35% of hospital stays.


Data source: IPRO, WhyNotTheBest.org, Q1/2014-Q4/2014 For details: www.americashealthrankings.org/ALL/recommended_hospital_care_sr


Measure: Recommended Hospital Care-Seniors, 2016 Senior Report
Source:
  • Improving Healthcare for the Common Good (WhyNotTheBest.org), 2014



Dedicated Health Care Provider

Older adults with a dedicated health care provider—compared with those without—are better positioned to receive care that can prevent, detect, and manage disease or other health conditions. Having a regular health care provider has been associated with improvements in preventive care and overall health status as well as improvements in chronic care management for asthma, hypertension, and diabetes. Individuals without a dedicated health care provider are more likely to visit the emergency department for non-urgent or avoidable problems. Seniors face numerous obstacles in obtaining a dedicated health care provider including limited access, financial constraints, and a general lack of knowledge of the services and providers available.


Data source: Behavioral Risk Factor Surveillance System, 2014 For details: www.americashealthrankings.org/ALL/dedicated_health_care_provider_sr


Measure: Dedicated Health Care Provider - Ages 65+, 2016 Senior Report
Measure: Dedicated Health Care Provider - Ages 65+, 2016 Senior Report

Why does this matter?

Individuals with a dedicated health care provider are better positioned to receive care that can prevent, detect and manage health conditions than those without a dedicated provider. Primary care providers are an integral part of the health and well-being of individuals, particularly older adults. Having a regular health care provider helps patients and providers build stable, long-term relationships that are associated with several benefits, including:

For older adults, obstacles to obtaining a dedicated health care provider include limited availability of services, financial constraints, lack of proper insurance coverage, lack of culturally competent care and language and transportation barriers.

Source:
  • CDC, Behavioral Risk Factor Surveillance System, 2014



Flu Vaccine

The flu vaccine helps protect individuals against seasonal influenza virus, a contagious respiratory infection that can lead to severe illness in older adults. Seniors are encouraged to receive the vaccine because they are at increased risk of contracting the virus. Additionally, almost 90% of flu-related deaths and more than half of hospitalizations are among older adults. Two forms of the flu vaccine are available for seniors: a regular-dose shot and a high-dose shot that elicits a stronger immune response. Flu vaccination is a highly cost-effective intervention and significantly reduces the number of hospitalizations in older adults. Medicare covers the cost of a single flu vaccination per year.


Data source: Behavioral Risk Factor Surveillance System, 2014 For details: www.americashealthrankings.org/ALL/flu_vaccine_sr


Measure: Flu Vaccination - Ages 65+, 2016 Senior Report
Measure: Flu Vaccination - Ages 65+, 2016 Senior Report

Why does this matter?

As immune defense systems weaken with age, older adults have an increased risk of contracting influenza (flu) viruses and having serious health complications as a result of infection. The flu vaccine helps protect individuals against seasonal flu viruses, which can pose a serious threat to the health of older adults. It is estimated that in recent years, the rate of flu-related deaths was highest among adults ages 65 and older compared with all other age groups.

Among adults ages 65 and older, the Centers for Disease Control and Prevention (CDC) estimated more than 1.9 million flu cases, nearly 177,000 flu-related hospitalizations and over 11,000 deaths occurred during the 2019-2020 flu season. Flu-related hospitalizations have decreased by around 50% among older adults who received flu shots, including those ages 75 and older.

Flu vaccination is a cost-effective intervention with direct cost savings estimated at more than $100 for every older adult receiving the vaccine. A recent study found that the annual economic burden of influenza among older adults ages 65 and older was $2.4 billion, including direct medical and indirect medical costs.

Source:
  • CDC, Behavioral Risk Factor Surveillance System, 2014



Health Screenings

Health screenings detect disease early when treatment is easiest. The US Preventive Services Task Force recommends screening for breast and colon cancer up to ages 74 and 75 respectively. Colon cancer risk increases with age, and more than half of breast cancer deaths occur in women aged 65 and older. Adults with health insurance or a usual source of care were more likely to report having received recommended cancer screenings than those without insurance or a usual source of care in 2013. Older adults are also recommended to have regular blood pressure, cholesterol, and diabetes screenings.


Data source: Behavioral Risk Factor Surveillance System, 2014 For details: www.americashealthrankings.org/ALL/health_screenings_sr


Measure: Cancer Screenings - Ages 65-75, 2016 Senior Report
Measure: Cancer Screenings - Ages 65-75, 2016 Senior Report

Why does this matter?

Screening may lead to early cancer detection, when treatment is easiest and most effective. This measure is limited to two types of cancer screenings — breast and colorectal cancer. Mammography and colorectal cancer screenings have saved many lives and are important methods to prevent cancer deaths. Of all age groups, women ages 60 to 69 years are most likely to avoid dying from breast cancer due to mammography screening. Experts agree on the cost-effectiveness of colorectal cancer screening compared with no screening — though estimates of potential cost-savings vary and studies disagree as to which screening method is most effective or offers the greatest savings. 

Despite their effectiveness in preventing cancers, the rates of mammography and colorectal cancer screening remain below national targets. Barriers to receiving cancer screenings include being uninsured and not having a usual source of care.

Source:
  • CDC, Behavioral Risk Factor Surveillance System, 2014


Diabetes Management

Diabetes is the seventh-leading cause of death in the United States and contributes to heart disease and stroke, the leading and fifth-leading causes of death respectively. It is the leading cause of kidney failure, non-traumatic lower limb amputations, and blindness in adults. Type 2 diabetes is a largely preventable condition that may be managed through lifestyle interventions and medications. The risk of diabetes increases with age; 25.9% of adults aged 65 and older have diagnosed or undiagnosed diabetes, compared with 16.2% of adults aged 45 to 64. Almost 60% of health care expenditures attributable to diabetes are for seniors, which amounts to an average annual per person cost of $11,825.


Data source: The Dartmouth Atlas of Health Care, 2013 For details: www.americashealthrankings.org/ALL/diabetes_management_sr


Measure: Diabetes Management, 2016 Senior Report
Source:
  • The Dartmouth Atlas of Health Care, 2013



Home Health Care

Home health and personal care aides enable seniors to remain in their homes after aging-related functional losses make independence difficult. A range of assistance is available, from skilled nursing services to basic assistance with activities of daily living. In-home and community-based services are less expensive than institutional services. National annual spending on long-term care services was estimated to be over $147 billion in 2009 with over 77% for nursing home care and only 23% for non-institutional services delivered in a person’s home. Providing more home-based services may reduce spending growth in the long-term care sector.


Data source: Bureau of Labor Statistics, 2015 For details: www.americashealthrankings.org/ALL/home_health_care_sr


Measure: Home Health Care Workers, 2016 Senior Report
Source:
  • ,



Preventable Hospitalizations

Preventable hospitalizations is an indicator of primary care quality. Seeking routine care in outpatient settings for non-emergent acute or chronic conditions could prevent complications, more severe disease, and the need for hospitalization. Discharges for ambulatory care-sensitive services are highly correlated with general admissions, reflecting general overuse of the hospital as a site for care. Hospital care makes up the largest component of national health spending, costing nearly $972 billion in 2014, and the majority of preventable hospital stays are among adults aged 65 and older. Preventable hospitalizations impose a nonessential financial burden on health care systems and can be avoided with less costly interventions.


Data source: The Dartmouth Atlas of Health Care, 2013 For details: www.americashealthrankings.org/ALL/preventable_hospitalizations_sr


Measure: Preventable Hospitalizations - Seniors, 2016 Senior Report
Source:
  • The Dartmouth Atlas of Health Care, 2013



Hospital Readmissions

Confusion about prescribed medications, miscommunication of important information, and improper follow-up care are among the many reasons patients are readmitted to the hospital. Some readmissions are unavoidable, but many are preventable and there are steps hospitals can take to reduce them. The Affordable Care Act established the Hospital Readmissions Reduction Program under which the Centers for Medicare & Medicaid Services is required to reduce payments to hospitals with excess readmissions. Hospital readmissions for Medicare patients alone cost about $26 billion annually; cases that may have been avoided with proper care cost $17 billion.


Data source: The Dartmouth Atlas of Health Care, 2013 For details: www.americashealthrankings.org/ALL/hospital_readmissions_sr


Measure: Hospital Readmissions, 2016 Senior Report
Source:
  • The Dartmouth Atlas of Health Care, 2013



Hospice Care

Hospice care is intended for terminally ill patients and emphasizes pain control and emotional support for patients and families. It can be provided in a health care facility or in a patient’s home. In 2014, seniors accounted for 84% of hospice patients and 85% of hospice patients were covered by the Medicare hospice benefit. The number of individuals receiving this care as well as the number of Medicare-certified hospices has dramatically increased in the past decade. Medicare covers certified services for patients with a life expectancy of six months or less. Expenditures for this benefit have rapidly increased over the past two decades to $13.8 billion in 2011.


Data source: The Dartmouth Atlas of Health Care, 2013 For details: www.americashealthrankings.org/ALL/hospice_care_sr


Measure: Hospice Care, 2016 Senior Report
Source:
  • The Dartmouth Atlas of Health Care, 2013



Hospital Deaths

Despite a societal preference for death at home or in a free-standing hospice facility, many seniors die in a hospital. In many circumstances dying in a hospital is avoidable through alternatives such as in-home hospice care. Studies show that patients who lack caregivers are more likely to die in an institution than patients with caregivers. In the past decade, the percentage of chronically ill Medicare patients dying in hospitals has declined, though this trend varies substantially by geography. End-of-life care in a hospital carries a high economic burden.


Data source: The Dartmouth Atlas of Health Care, 2013 For details: www.americashealthrankings.org/ALL/hospital_deaths_sr


Measure: Hospital Deaths, 2016 Senior Report
Source:
  • The Dartmouth Atlas of Health Care, 2013


Please tell us a little more about you

We appreciate you taking the time to help America’s Health Rankings better understand our audiences. Your feedback will allow us to optimize our website and provide you with additional resources in the future. Thank you.

Please select one option which best describes your profession or field of expertise

Journalist or media professional
Health Policy Professional
Public health professional (state, local, or community level)
Health care provider or administrator
Member of an advocacy group or trade organization
Academic, student, or researcher
Government administrator, legislator, or staffer
Concerned citizen
Other
Don't show me this again
Please take a quick survey.