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- Title
Prevalence and patterns of potentially avoidable hospitalizations in the US long-term care setting.
- Authors
MCANDREW, ROSEMARY M.; GRABOWSKI, DAVID C.; DANGI, ANKIT; YOUNG, GARY J.
- Abstract
<bold>Objective: </bold>We examined the magnitude and related costs of potentially avoidable hospitalizations including re-hospitalizations for long-stay residents in nursing homes.<bold>Design: </bold>We conducted our investigation as a retrospective cohort study where the cohort comprised individuals who were eligible for Medicare and had spent at least 120 uninterrupted days in a nursing home in New York State between 2004 and 2007. To conduct the study, we linked the Minimum Data Set, Medicare Provider Assessment File and Provider of Service File.<bold>Measurements: </bold>We defined a potentially avoidable hospitalization as one where a resident was admitted to a hospital for which the principle diagnosis was 1 of 15 ambulatory care sensitive (ACS) conditions.<bold>Results: </bold>Although the percentage of total hospitalizations for ACS conditions declined during the study period, 20% or more of annual hospitalizations were for ACS conditions entailing Medicare payments in excess of $450 million. Approximately 40% of the residents who were hospitalized once for an ACS condition were re-hospitalized during the study period for the same or different ACS condition.<bold>Conclusion: </bold>During the study period, potentially avoidable hospitalizations from nursing homes were a common occurrence in New York. A substantial percentage of such hospitalizations involved residents who had been previously hospitalized, in some cases multiple times, for an ACS condition. Although the observed decline in ACS-related hospitalizations suggests improvements in nursing home care, various policy and managerial-level initiatives may be needed to ensure that nursing home residents are not exposed to a substantial risk of avoidable hospitalizations in the future.
- Subjects
UNITED States; NEW York (State); MEDICAL care costs; MEDICARE; OUTPATIENT medical care nursing; NURSING care facilities; HOSPITAL care; ECONOMIC impact; LONG-term health care; MEDICAL care research; DISEASE prevalence; RETROSPECTIVE studies; ECONOMICS
- Publication
International Journal for Quality in Health Care, 2016, Vol 28, Issue 1, p104
- ISSN
1353-4505
- Publication type
journal article
- DOI
10.1093/intqhc/mzv110