Blog & News
State Health Compare Data Highlight: Potentially Preventable HospitalizationsMay 29, 2019:
More expensive than outpatient or primary care, hospitalization contributes substantially to healthcare costs, with hospital care accounting for 33% of healthcare spending, or $1.1 trillion, in 2017. Reducing potentially preventable hospitalizations—i.e., hospital admissions for certain acute illnesses or chronic conditions that might not have required hospitalization if they had been better managed through outpatient primary care—is therefore a key mechanism by which healthcare costs can be reduced. National and state-level data on potentially preventable hospitalizations allow policymakers and analysts to track and monitor trends in this area, assess progress or setbacks, and consider policy levers that could effect change.
State Health Compare: A Unique Source of State-Level Estimates on Potentially Preventable Hospitalizations
SHADAC’s State Health Compare is the only publicly accessible source of state-level measures on potentially preventable hospitalizations, with three measures available: 1) per person cost of potentially preventable hospitalizations; 2) rates of potentially preventable adult hospitalizations; and 3) rates of potentially preventable child hospitalizations. These measures are available for 2009 through 2015 (the most recent year available).
About the Data
State Health Compare uses data from the Health Care Cost and Utilization Project (HCUP) to produce the above measures. HCUP is a collection of national and state inpatient and emergency department databases that constitutes the largest available all-payer longitudinal hospital care data source. HCUP data are derived from hospital administrative discharge records originally used for hospital billing procedures. State Health Compare’s national estimates were calculated using HCUP’s Nationwide Inpatient Sample (NIS), and state-specific results were calculated using HCUP’s State Inpatient Databases (SID) along with state inpatient databases purchased directly from states.
State Health Compare Highlights from 2015
- In 2015, per person costs of potentially preventable hospitalizations averaged $129 nationwide. Among the states, costs ranged from $70 per person in Colorado to $215 per person in the District of Columbia.
- The national average for potentially preventable hospitalizations per 100,000 adults was 1,520 in 2015, compared to a low of 867 in New Mexico and a high of 2,061 in the District of Columbia.
- The rate of potentially preventable hospitalizations per 100,000 children averaged 131 nationwide in 2015. Among the states, this rate ranged from 46 in Vermont to 260 in the District of Columbia.
Data on potentially preventable hospitalizations can be used as evidence in support of multiple policy interventions. For example, these data point to the need for policies that would increase preventive service utilization as well as policies that would increase utilization of effective primary care–both strategies that are shown to reduce potentially preventable hospitalizations. ,
In 2016, SHADAC published a report on using HCUP data for State Health Policy Analysis, available here.
Agency for Healthcare Research and Quality. (2019). HCUP Overview, Healthcare Cost and Utilization Project (HCUP). Available at: https://www.hcup-us.ahrq.gov/overview.jsp
 Centers for Medicaid & Medicaid Services (CMS). National Health Expenditures 2017 Highlights [PDF File]. Available at: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/downloads/highlights.pdf
 SHADAC used the first three quarters of 2015 data for the 2015 estimates because HCUP switched from ICD-9 to ICD-10 coding in the fourth quarter of 2015. The next year of data will continue to use ICD-10 codes. When SHADAC publishes the 2016 HCUP data, we will indicate a break in series.
 There are some states where the data are not available (or not supplied to the Health Care Cost and Utilization Project) or for which data are suppressed because of reliability issues.
 “Introduction” in The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Yong, P.L., Saunders, R.S., Olsen, L.A., eds. National Academies Press (US), 2010. Available at: https://www.ncbi.nlm.nih.gov/books/NBK53914/
 Agency for Healthcare Research and Quality (AHRQ). Chartbook on Care Coordination: Potentially Avoidable Hospitalizations. Content last reviewed June 2018. Available at: https://www.ahrq.gov/research/findings/nhqrdr/chartbooks/carecoordination/measure3.html