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Adult Potentially Preventable Hospitalizations in Texas

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Adult Potentially Preventable Hospitalizations in Texas 2014 Crossroads Conference: Navigating Health Care in West Texas June 5, 2014 Mike Gilliam, Jr., M.S.W., M.P.H. – PowerPoint PPT presentation

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Title: Adult Potentially Preventable Hospitalizations in Texas


1
Adult Potentially Preventable Hospitalizations in
Texas
  • 2014 Crossroads Conference Navigating Health
    Care in West Texas June 5, 2014
  • Mike Gilliam, Jr., M.S.W., M.P.H. Assessment
    Benchmarking Specialist Texas Department of State
    Health Services (DSHS)

2
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
  • Since 2008, DSHS has educated communities and
    policymakers on the impact of these ten adult
    potentially preventable hospitalization
    conditions
  • 1. Bacterial Pneumonia
  • 2. Dehydration
  • 3. Urinary Tract Infection (UTI)
  • 4. Angina (without procedures)
  • 5. Congestive Heart Failure (CHF)
  • 6. Hypertension
  • 7. Asthma
  • 8. Chronic Obstructive Pulmonary Disease
    (COPD)
  • 9. Diabetes Short-term (ST) Complications
    and
  • 10. Diabetes Long-term (LT) Complications.
  • Adult hospitalizations for these conditions are
    considered potentially preventable, because if
    the individual had access to and cooperated with
    appropriate outpatient healthcare, the
    hospitalization would likely not have occurred.

3
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
Bacterial Pneumonia is a serious inflammation of the lungs caused by an infection. Bacterial pneumonia primarily impacts older adults. Communities can potentially prevent hospitalizations by encouraging older adults and other high risk individuals to get vaccinated for bacterial pneumonia.
Dehydration means the body does not have enough fluid to function well. Dehydration primarily impacts older adults or institutionalized individuals who have a limited ability to communicate thirst. Communities can potentially prevent hospitalizations by encouraging attention to the fluid status of individuals at risk.
UTI is usually caused when bacteria enter the bladder and cause inflammation and infection. It is a common condition, with older adults at highest risk. In most cases, an uncomplicated UTI can be treated with proper antibiotics. Communities can potentially prevent hospitalizations by encouraging individuals to practice good personal hygiene drink plenty of fluids and (if practical) avoid conducting urine cultures in asymptomatic patients who have indwelling urethral catheters.
Angina (without procedures) is chest pain that occurs when a blockage of a coronary artery prevents sufficient oxygen-rich blood from reaching the heart muscle. Communities can potentially prevent hospitalizations by encouraging regular physical activity smoking cessation controlling diabetes, high blood pressure, and abnormal cholesterol maintaining appropriate body weight and daily administration of an anti-platelet medication (like low dose aspirin) in most individuals with known coronary artery disease.
CHF is the inability of the heart muscle to function well enough to meet the demands of the rest of the body. Communities can potentially prevent hospitalizations by encouraging individuals to reduce risk factors such as coronary artery disease, diabetes, high cholesterol, high blood pressure, smoking, alcohol abuse, and use of illegal drugs.
4
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
Hypertension is a syndrome with multiple causes. Hypertension is often controllable with medications. Communities can potentially prevent hospitalizations by encouraging an increased level of aerobic physical activity, maintaining a healthy weight, limiting the consumption of alcohol to moderate levels for those who drink, reducing salt and sodium intake, and eating a reduced-fat diet high in fruits, vegetables, and low-fat dairy food.
Asthma occurs when air passages of the lungs become inflamed and narrowed and breathing becomes difficult. Asthma is treatable, and most flare-ups and deaths can be prevented through the use of medications. Communities can potentially prevent hospitalizations by encouraging people to learn how to recognize particular warning signs of asthma attacks. Treating symptoms early can result in prevented or less severe attacks.
COPD is characterized by decreased flow in the airways of the lungs. It consists of three related diseases asthma, chronic bronchitis and emphysema. Because existing medications cannot change the progressive decline in lung function, the goal of medications is to lessen symptoms and/or decrease complications. Communities can potentially prevent hospitalizations by encouraging education on smoking cessation and minimizing shortness of breath.
Diabetes ST Complications are extreme fluctuations in blood sugar levels. Extreme dizziness and fainting can indicate hypoglycemia (low blood sugar) or hyperglycemia (high blood sugar), and if not brought under control, seizures, shock or coma can occur. Diabetics need to monitor their blood sugar levels carefully and adjust their diet and/or medications accordingly. Communities can potentially prevent hospitalizations by encouraging the regular monitoring and managing of diabetes in the outpatient health care setting and encouraging patient compliance with treatment plans.
Diabetes LT Complications include risk of developing damage to the eyes, kidneys and nerves. Risk also includes developing cardiovascular disease, including coronary heart disease, stroke, and peripheral vascular disease. Long-term diabetes complications are thought to result from long-term poor control of diabetes. Communities can potentially prevent hospitalizations by encouraging the regular monitoring and managing of diabetes in the outpatient health care setting and encouraging patient compliance with treatment plans.
5
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
  • Methodology to identify Potentially Preventable
    Hospitalizations was developed by the Agency for
    Healthcare Research and Quality (AHRQ). AHRQ is
    the lead federal agency responsible for research
    on healthcare quality costs, outcomes and patient
    safety.
  • Potentially Preventable Hospitalizations are also
    referred to as Ambulatory Sensitive Conditions,
    Prevention Quality Indicators and/or Potentially
    Preventable Admissions/Events.
  • Potentially Preventable Hospitalization data is
    based on primary diagnosis.
  • Potentially Preventable Hospitalization data is
    based on county of residence not the county
    where the individual was hospitalized.

6
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
  • The purpose of this information is to assist in
    improving healthcare and reducing healthcare
    costs.
  • This information is not an evaluation of
    hospitals or other healthcare providers.
  • This information can be used as a tool to assess
    a communitys outpatient healthcare system.
  • Inpatient hospital data in Texas is available
    from the Texas Health Care Information Collection
    (www.dshs.state.tx.us/thcic), in the Center for
    Health Statistics, at DSHS.

7
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
  • From 2007-2012, adult residents of Texas
    received approximately 47.4 Billion (B) in
    charges for 1,459,249 hospitalizations that were
    potentially preventable.
  • 47.4 B equals 2,483 for every adult Texan.
  • Allocation of the 47.4 B by Expected Primary
    Source of Payment
  • ...Medicare 30.0 B (63.3)
  • Private Health Insurance 8.5 B (18.0)
  • Uninsured 4.6 B (09.7)
  • Medicaid 3.2 B (06.8)
  • Other 1.1 B (02.2)
  • Combination of ten adult potentially preventable
    hospitalization conditions (2007-2012).

8
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
  • Number of Hospitalizations 1,459,249
  • Average Hospital Charge 32,464
  • Average Length of Hospital Stay 4.9 Days
  • Average Age of Individual Hospitalized 63 Years
  • Combination of ten adult potentially preventable
    hospitalization conditions (2007-2012).

9
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
Adult Residents of Texas (2007-2012) Bacterial Pneumonia Dehydration UTI Angina w/o procedures CHF Hyper- tension COPD or Older Adult Asthma Diabetes ST Diabetes LT
Hospitalizations 293,857 94,531 205,318 15,762 338,497 65,962 252,777 59,617 132,928
Female 55.8 62.4 74.6 55.2 51.6 62.8 62.4 51.7 47.1
Male 44.2 37.6 25.4 44.8 48.4 37.2 37.6 48.3 52.9

White 72.6 71.3 69.0 66.4 63.7 49.8 74.2 53.6 53.4
Black 10.2 11.3 10.9 14.0 18.4 31.1 13.0 25.2 19.4
Other (Race) 17.0 17.0 19.8 18.5 17.6 18.9 12.5 21.1 27.0

Hispanic 19.1 19.9 24.3 23.4 21.6 23.4 13.8 26.7 36.0
Values of less than 3 are included in Other
Texas (U.S. Census 2010, Adult Population) White
(Race) 72.2 Black (Race) 11.6 Other
(Race) 16.2 Hispanic (Ethnicity) 33.6
10
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
Adult Residents of Texas (2007-2012) Bacterial Pneumonia Dehydration UTI Angina w/o Procedures CHF Hyper- Tension COPD or Older Adult Asthma Diabetes ST Diabetes LT
Hospitalizations 293,857 94,531 205,318 15,762 338,497 65,962 252,777 59,617 132,928
Average Age 65 Years 64 Years 65 Years 58 Years 68 Years 58 Years 67 Years 38 Years 57 Years
Age
18-19 Years 6.5
20-29 Years 6.2 24.2
30-39 Years 3.2 6.2 4.8 19.4 7.9
40-49 Years 8.1 8.8 7.3 16.6 3.6 16.8 9.5 19.8 16.2
50-59 Years 13.6 13.4 9.7 26.8 13.2 21.4 19.0 16.0 24.6
60-69 Years 17.4 16.5 12.9 23.0 20.2 18.3 26.0 8.1 22.3
70-79 Years 22.1 20.9 20.2 16.5 25.0 16.8 26.8 15.9
80-89 Years 23.1 21.7 26.7 10.0 25.8 13.7 16.2 9.0
90 Years 7.6 6.9 9.4 7.7 3.1
Other 8.3 8.7 1.3 7.1 4.5 5.1 2.5 6.0 4.2
Values of less than 3 are included in Other
11
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
Adult Residents of Texas (2007-2012) Bacterial Pneumonia Dehydration UTI Angina w/o procedures CHF Hyper Tension COPD or Older Adult Asthma Diabetes ST Diabetes LT
Hospitalizations 293,857 94,531 205,318 15,762 338,497 65,962 252,777 59,617 132,928
Discharged to
Home/Self-Care 61.6 68.2 57.8 77.0 59.9 84.2 71.8 86.3 59.8
Skilled Nursing Facility 11.5 10.7 17.8 10.4 3.5 6.7 8.7
Home Health 10.7 9.6 11.6 3.1 14.7 6.7 11.5 4.3 16.4
Intermediate Care Facility 3.9
ST Hospital 12.5
Medicare Certified LT Hospital 5.9
Left Against Medical Advice 3.5
Died 3.3
Other 12.7 11.2 8.8 7.1 14.7 5.2 9.8 5.7 9.0
Values of less than 3 are included in Other
12
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
Adult Residents of Texas (2007-2012) Bacterial Pneumonia Dehydration UTI Angina w/o procedures CHF Hyper tension COPD or Older Adult Asthma Diabetes ST Diabetes LT
Hospitalizations 293,857 94,531 205,318 15,762 338,497 65,962 252,777 59,617 132,928
Expected Primary Source of Payment
Medicare 65.1 61.5 66.2 45.0 73.5 46.2 66.8 20.0 53.5
Private Health Insurance 19.6 24.8 16.2 32.5 12.0 25.1 16.6 29.1 20.4
Uninsured 8.0 6.6 9.2 12.4 6.9 18.2 7.3 32.1 13.2
Medicaid 5.4 5.0 6.4 6.1 5.9 7.2 7.2 13.9 10.0
Other 1.9 2.1 1.9 4.1 1.7 3.2 2.1 4.9 2.9

Avg. Length of Hospital Stay 5.4 days 3.6 days 4.3 days 2.3 days 5.3 days 3.2 days 4.6 days 3.7 days 6.7 days
Avg. Hospital Charge 34,736 19,984 23,880 22,962 40,252 23,952 29,738 25,275 43,505
Total Approximate Hospital Charges 10.2 B 1.9 B 4.9 B 361.9 M 13.6 B 1.6 B 7.5 B 1.5 B 5.8 B
B means Billion M means Million
Values of less than 3 are included in Other
13
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
  • Combined, Bacterial Pneumonia and CHF comprise
  • 43.3 (632,354) of admissions for Potentially
    Preventable Hospitalizations and
  • 50.2 (23.8 B) of charges for Potentially
    Preventable Hospitalizations.
  • Combination of ten adult potentially preventable
    hospitalization conditions (2007-2012).

14
Adult Potentially Preventable Hospitalizations in
Texas
Secondary Diagnosis of Mental Illness/Substance
Abuse in Adult Potentially Preventable
Hospitalizations in Texas (2006-2010)
Adult Residents of Texas (2006-2010) Bacterial Pneumonia Dehydration UTI Angina w/o procedures CHF Hyper- Tension Asthma COPD Diabetes ST Diabetes LT
Hospitalizations 250,721 68,557 160,599 14,984 296,953 51,817 77,900 145,200 45,192 108,078
Mental Illness/ Substance Abuse (Secondary Diagnosis) 32.5 31.0 36.1 31.3 20.6 30.9 37.0 44.4 29.3 20.3
For example, 32.5 of the 250,721 adult
potentially preventable hospitalizations for
Bacterial Pneumonia (2006-2010) had a secondary
diagnosis of mental illness/substance abuse.
Alcohol and other Drug Diagnoses (Excluding
Tobacco Use Disorder) are Significantly
Underrepresented Due to Data Suppression
Requirements.
15
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
16
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
  • In-depth data profiles are available with the
    following information
  • Years (2007-2012)
  • Condition (Ten Conditions)
  • County
  • Age Group
  • Sex
  • Race
  • Ethnicity
  • Zip Code of Residence
  • Hospitalized at
  • Average Length of Hospital Stay
  • Average Hospital Charge
  • Total Hospital Charges
  • Discharged to and
  • Expected Primary Source of Payment.
  • To request an in-depth profile, send an email to
    mike.gilliam_at_dshs.state.tx.us.

17
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
Example of In-Depth Data Profile
LUBBOCK COUNTY Adult Residents Diabetes Short-term Complications Potentially Preventable Hospitalizations (2007-2012) LUBBOCK COUNTY Adult Residents Diabetes Short-term Complications Potentially Preventable Hospitalizations (2007-2012) LUBBOCK COUNTY Adult Residents Diabetes Short-term Complications Potentially Preventable Hospitalizations (2007-2012) LUBBOCK COUNTY Adult Residents Diabetes Short-term Complications Potentially Preventable Hospitalizations (2007-2012) LUBBOCK COUNTY Adult Residents Diabetes Short-term Complications Potentially Preventable Hospitalizations (2007-2012)

Total Hospitalizations 1,133                                    
                                       
Age                                     Zip Code of Residence
18-19 Years 04.2                                     79403 13.2
20-29 Years 32.4                                     79416 09.5
30-39 Years 19.8                                     79423 07.8
40-49 Years 16.4                                     79411 07.8
50-59 Years 12.8                                     79415 07.7
60-69 Years 08.5                                     79407 07.6
Other 05.9                                     79412 07.1
                                    79413 06.5
Female 49.4                                     79424 06.2
Male 50.6                                     79414 05.6
                                    79404 05.6
White (Race) 70.7                                     79401 05.6
Black (Race) 19.4                                     Other 03.6
Other (Race) 09.9                                    
Hispanic (Ethnicity) 39.3                                     The adult (18) population of Lubbock County is approximately 09.0 Black and 28.6 Hispanic. The adult (18) population of Lubbock County is approximately 09.0 Black and 28.6 Hispanic.
18
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
Example of In-Depth Data Profile
LUBBOCK COUNTY Adult Residents Diabetes Short-term Complications Potentially Preventable Hospitalizations (2007-2012) LUBBOCK COUNTY Adult Residents Diabetes Short-term Complications Potentially Preventable Hospitalizations (2007-2012) LUBBOCK COUNTY Adult Residents Diabetes Short-term Complications Potentially Preventable Hospitalizations (2007-2012) LUBBOCK COUNTY Adult Residents Diabetes Short-term Complications Potentially Preventable Hospitalizations (2007-2012) LUBBOCK COUNTY Adult Residents Diabetes Short-term Complications Potentially Preventable Hospitalizations (2007-2012)

Total Hospitalizations 1,133                                    
                                       
Place of Hospitalizations                                     Expected Primary Source of Payment  
University Medical Center 68.0                                     Medicaid 17.9
Covenant Medical Center 26.3                                     Medicare 22.7
Other 05.8                                     Private Health Insurance 23.7
                                    Uninsured 32.5
Average Length of Stay 4.3 Days                                     Other 03.2
Average Hospital Charge 26,694                                    
Total Hospital Charges 30,244,581                                     Discharged to
                                    Home/Self Care 87.0
                                    Home Health 05.2
                                    Skilled Nursing Facility 03.1
                                    Other 04.2
19
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
Efforts to Reduce Adult Potentially Preventable
Hospitalizations The 82nd Texas Legislature
appropriated 2 M for DSHS to implement the
Reducing Adult Potentially Preventable
Hospitalizations Initiative in FY 12/13. DSHS
contracted with 16 counties to implement
evidence-based interventions, through a community
coordinated approach, to reduce hospitalizations
and/or hospital charges among adult county
residents for selected potentially preventable
hospitalization conditions. Adult residents in
each of the 16 counties had a hospitalization
rate more than 50 higher than the state rate
from 2005-2009. Each of the 16 counties had a
Project Contact that coordinates monthly
coalition meetings to maximize implementation of
one or more of the following evidence-based
interventions immunizations patient education
community education smoking cessation
healthcare provider education diabetes
self-management education patient case
management nutrition physical activity weight
management glycemic control and blood pressure
control.

20
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
21
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
FY12/13 Reducing Adult Potentially Preventable
Hospitalizations Initiative (01/01/12 08/31/13)


County Hospitalization Condition(s) Project Contact Email
Angelina Bacterial Pneumonia, Dehydration UTI Sharon Shaw (Angelina Co. Cities Health District) sshaw_at_acchd.us  
Brooks Bacterial Pneumonia Diana Bill (Community Action Corp. of S TX) diana.bill_at_cacost.org
Ector Asthma COPD Sherrill Rhodes (Medical Ctr. Health System) srhodes_at_echd.org
Grayson Bacterial Pneumonia, Dehydration UTI John Teel (Grayson Co. Health Dept.) teelj_at_co.grayson.tx.us
Hunt Bacterial Pneumonia COPD Pam Andrews (Hunt Co. Health Dept.) pandrews_at_huntcounty.net  
Liberty Bacterial Pneumonia, CHF COPD Steven Racciato (Health Ctr. of SE TX) fqhc1_at_sbcglobal.net
Limestone Bacterial Pneumonia CHF Kimberly Meyer (Limestone Medical Ctr.) kmeyer_at_lmchospital.com  
Nacogdoches Dehydration UTI Kinnie Douglas (Nacogdoches Memorial Hospital) douglask_at_nacmem.org
Orange Bacterial Pneumonia, CHF COPD Jarren Garrett (Baptist Hospitals of SE TX Orange) jarren.garrett_at_bhset.net
Polk Bacterial Pneumonia, CHF COPD Jerry Hathorn (Polk Co. Health Advisory Coalition) jerry.hathorn_at_dshs.state.tx.us  
Red River CHF COPD Marleah Drew (Lennox Health Resources) mdlennoxhrc_at_cebridge.net  
San Augustine Bacterial Pneumonia Sharon Shaw (Angelina Co. Cities Health District) sshaw_at_acchd.us  
Tom Green Bacterial Pneumonia, UTI COPD Dianna Spieker (Tom Green Co.) dianna.spieker_at_co.tom-green.tx.us
Trinity Bacterial Pneumonia, UTI COPD Carl Dyer (Trinity Co.) carl.dyer_at_co.trinity.tx.us  
Victoria Bacterial Pneumonia, CHF Diabetes Robbyn Michalka (Texas AHEC East Victoria Region) robbyn.michalka_at_victoriacollege.edu
Walker Hypertension Diabetes Meredith Henry (Texas AgriLife Walker Co.) mdhenry_at_ag.tamu.edu
22
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
FY14/15 Reducing Adult Potentially Preventable
Hospitalizations Initiative (09/01/13
08/31/15) DSHS re-contracted with 13 of the 16
counties funded in FY12/13.


County Hospitalization Condition(s) Project Contact Email
Angelina Bacterial Pneumonia, Dehydration, UTI Hypertension Ann Watson (Angelina Co. Cities Health District) awatson_at_acchd.us  
Brooks Bacterial Pneumonia Dehydration Diana Bill (Community Action Corp. of S TX) diana.bill_at_cacost.org
Ector Asthma, COPD Diabetes Dianna Ruiz (Medical Ctr. Health System) dhuerta_at_echd.org
Grayson Bacterial Pneumonia, Dehydration, UTI COPD Sandra Clark (Grayson Co. Health Dept.) sandrac_at_co.grayson.tx.us
Limestone Bacterial Pneumonia , CHF COPD Kimberly Meyer (Limestone Medical Ctr.) kmeyer_at_lmchospital.com  
Orange Bacterial Pneumonia, Angina, CHF COPD Jarren Garrett (Baptist Hospitals of SE TX Orange) jarren.garrett_at_bhset.net
Polk Bacterial Pneumonia, Dehydration, CHF COPD Jerry Hathorn (Polk Co. Health Advisory Coalition) jerry.hathorn_at_dshs.state.tx.us  
Red River CHF, COPD Diabetes Tammy Lawing (Lennox Health Resources) tglawing_at_etmc.org  
San Augustine Bacterial Pneumonia Hypertension Ann Watson (Angelina Co. Cities Health District) awatson_at_acchd.us  
Tom Green Bacterial Pneumonia, Dehydration, UTI COPD Dianna Spieker (Tom Green Co.) dianna.spieker_at_co.tom-green.tx.us
Trinity Bacterial Pneumonia, UTI, Hypertension COPD Carl Dyer (Trinity Co.) carl.dyer_at_co.trinity.tx.us  
Victoria Bacterial Pneumonia, Angina, CHF Diabetes Robbyn Michalka (Texas AHEC East Victoria Region) robbyn.michalka_at_victoriacollege.edu
Walker Hypertension, Asthma Diabetes Meredith Henry (Texas AgriLife Walker Co.) mdhenry_at_ag.tamu.edu
23
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
TRENDS Adult Potentially Preventable
Hospitalizations
Adult Residents of Texas (2006-2011) Bacterial Pneumonia Dehydration UTI Angina w/o procedures CHF Hyper- Tension Asthma in Younger Adults COPD or Asthma in Older Adults Diabetes ST Diabetes LT
Risk-Adjusted Rate Per 100,000
2011 297.5 85.5 199.1 15.8 307.0 51.5 30.1 366.0 46.1 107.3
2010 326.9 95.7 208.4 18.4 337.0 56.3 37.9 418.9 42.8 106.7
2009 344.7 112.0 206.0 24.1 353.5 55.6 40.5 432.5 41.0 104.8
2008 360.8 137.2 196.2 26.7 366.6 53.9 31.0 462.2 39.5 110.2
2007 408.6 152.8 206.5 32.4 424.6 58.6 36.5 414.0 37.8 110.2
2006 408.8 162.3 214.7 42.4 469.6 56.4 41.9 420.3 36.0 122.8
18-39 Years of Age 40 Years of Age
Note AHRQ recently released new methodology that
separates Asthma Potentially Preventable
Hospitalizations into two conditions Asthma in
Younger Adults and COPD or Asthma in Older
Adults. The table above reflects this new
methodology.
24
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
TRENDS Adult Potentially Preventable
Hospitalizations
Discharge Rate for Medicare Population Diagnoses Amenable to Non-Hospital Based-Care Texas U.S.
Number per 1,000 Medicare Enrollees
2013 Report (2011 data) 67.9 64.9
2012 Report (2010 data) 72.3 66.6
2011 Report (2009 data) 72.8 68.2
2010 Report (2008 data) 78.7 70.6
2009 Report (2007 data) 81.2 74.2
2008 Report (2006 data) 87.6 78.4
2007 Report (2005 data) 87.6 78.4
2006 Report (2004 data) 87.6 77.0
Source Americas Health Rankings United Health
Foundation
  • Comparing the 2013 Report to the 2010 Report, the
    discharge rate in Texas decreased 13.7, as
    compared to the discharge rate in the U.S. which
    decreased 8.1.

25
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
TRENDS Adult Potentially Preventable
Hospitalizations
Adult Residents Overall Prevention Quality Indicator (PQI) Rate Freestone County Red River County TEXAS
Risk-Adjusted Rate Per 100,000
2011 1,974.9 4,451.5 1,357.7
2008 2,712.8 6,051.7 1,596.9
Overall PQI Rate is an AHRQ aggregate calculation
of all adult potentially preventable
hospitalizations.
  • From 2008 to 2011, the overall PQI rate for adult
    residents of
  • Freestone County decreased 27.2
  • Red River County decreased 26.4 and
  • Texas decreased 15.0.

Under the leadership of the county judge in 2008,
community health coalitions in Freestone and Red
River County worked with DSHS to use the
potentially preventable hospitalization data to
attempt to reduce adult potentially preventable
hospitalizations. For example, both counties
implemented vaccine outreach campaigns targeting
Bacterial Pneumonia.
26
Adult Potentially Preventable Hospitalizations in
Texas (2007-2012)
  • Project Website (www.dshs.state.tx.us/ph)
  • State Profile
  • Profiles on all 254 counties in Texas
  • Clinical Interventions
  • Maps illustrating the impact of potentially
    preventable hospitalization conditions in Texas
    counties and
  • Funded Counties (Reducing Adult Potentially
    Preventable Hospitalizations Initiative) .
  • Contact Information
  • Mike Gilliam, Jr. (512)776-2708
    mike.gilliam_at_dshs.state.tx.us
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