National Healthcare Disparities Report - LDI Health Economist

Efficiency
n From 2003 to 2005, the percentage of older patients who received at least 1 of 33 potentially
inappropriate drugs was significantly lower for Hispanics than for Whites. For the rest of the period,
there were no statistically significant differences (Figure 7.1).
n From 2002 to 2008, the percentage of adults age 65 and over that received potentially inappropriate
medications decreased from 19% in 2002 to 13% in 2008 (data not shown).
n There was a consistent gap between males and females, with females having higher rates of
inappropriate medications. In 2008, the rate for females was 16% and 11% for males.
Also, in the National Healthcare Quality Report (NHQR):
n From 2002 to 2008, there were no consistent gaps between patients with Medicare and private
insurance and those with Medicare only or with Medicare and other public insurance.
Preventable Hospitalizations
Chapter 7
NEW
Potentially Avoidable Hospitalization Rates for Adults
Hospitalization is expensive. Preventing avoidable hospitalizations could improve the efficiency of health
care delivery. To address potentially avoidable hospitalizations from the population perspective, data on
ambulatory care-sensitive conditions are summarized here using the AHRQ Prevention Quality Indicators
(PQIs). Not all hospitalizations that the AHRQ PQIs track are preventable. But ambulatory care-sensitive
conditions are those for which good outpatient care can prevent the need for hospitalization or for which
early intervention can prevent complications or more severe disease.
The AHRQ PQIs track these conditions using hospital discharge data. Hospitalizations for acute conditions,
such as dehydration or pneumonia, are distinguished from hospitalizations for chronic conditions, such as
diabetes or congestive heart failure. Results presented this year apply a modified version 4.1 of the AHRQ
Quality Indicators and are not comparable to results from previous years.
A critical caveat should be noted regarding potentially avoidable hospitalizations. Comparatively high rates of
potentially avoidable hospitalizations may reflect inefficiency in the health care system. Therefore, groups of
patients should not be “blamed” for receiving less efficient care. Instead, examining disparities in efficiency
may help make the business case for addressing disparities in care. Investments that reduce disparities in
access to high-quality outpatient care may help reduce rates of avoidable hospitalizations among groups that
have high rates.
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