The nation spends billions annually on preventable hospitalizations1

This indicator provides the rates of preventable hospitalizations (per 100,000 population) for selected conditions.  It is based upon a composite indicator for twelve ambulatory care-sensitive conditions. Examples include diabetes complications, adult asthma, hypertension, heart failure, dehydration, urinary tract infection, and bacterial pneumonia. Hospitalizations due to these conditions are potentially preventable through access to high-quality outpatient care.1 

Indicator Progress

In 2011 (baseline year), there were 1,291 preventable hospitalizations for selected conditions per 100,000 population. The most recent rate available is 990 (2017). We hope to reach a target of 727 or lower by 2022.

Note: Due to the transition from ICD-9 to ICD-10 in October 2015, comparisons cannot be made between 2015 (or earlier) and 2016 (or later). The status for this indicator is pending until an ICD-10 trend can be established.

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Preventable Hospitalizations

Note: Due to changes in the way this indicator is calculated each year, the baseline value must also be re-calculated in order to be appropriately compared to the current value. Therefore, the baseline value may slightly change with each year.

Baseline

1,291

Current Rate

990

Target

727

Indicator Highlights

In California, over $3.5 billion is spent on hospitalizations that are potentially preventable with better outpatient care.1

Hospital costs for preventable hospitalizations in California exceed $3.5 billion.1

Preventable Hospitalizations per 100,000 Population, Over Time

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Preventable Hospitalizations per 100,000 Population, by County

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Indicator: Preventable Hospitalizations per 100,000 population

Description: This indicator provides the Statewide and County overall rates of Preventable Hospitalizations (for Selected Conditions). For 2005-2015, the risk-adjusted rates are displayed; in 2016, the observed rates are shown.

The indicator is based upon Agency for Healthcare Research & Quality (AHRQ) Prevention Quality Indicator (PQI) #90.  PQI #90 is the composite indicator for 11 (previously 12) ambulatory care-sensitive conditions.  Hospitalizations due to these conditions are potentially preventable through access to high-quality outpatient care.

The conditions include diabetes short-term complications, diabetes long-term complications, chronic obstructive pulmonary disease (COPD) or asthma in older adults (age 40 and over), hypertension, heart failure, dehydration, bacterial pneumonia, urinary tract infection, angina without procedure (retired in 2016), uncontrolled diabetes, asthma in younger adults (age 18-39), and lower-extremity amputation among patients with diabetes.

The indicator was calculated using the California Office of Statewide Health Planning & Development (OSHPD) Patient Discharge Data run through AHRQ’s Prevention Quality Indicator Software, Version 5.0 (2005-2015) and Version 6.01 (2016).

Data Limitations:  The indicator rate was calculated using AHRQ’s Prevention Quality Indicator Software, Version 5.0 (2005-2015) and Version 6.01 (2016).  Rate comparisons that use prior versions of the software may not be directly comparable as they likely use a different referent or denominator population and possibly use conditions that have since been redefined. In addition, data for 2016 are no risk-adjusted (observed rates) and should not be compared to each other.

Values for 2016 are ICD-10 Observed Rates. Values previous to this are ICD-9 Risk-Adjusted Rates. The two cannot be compared to each other.

Indicator Source: OSHPD – Healthcare Analytics Branch

Indicator Calculation Methodology:

http://oshpd.ca.gov/HID/Products/PatDischargeData/AHRQ/pqi_overview.html

http://www.qualityindicators.ahrq.gov/Downloads/Modules/PQI/V50/TechSpecs/PQI_90_Prevention_Quality_Overall_Composite_.pdf

https://www.qualityindicators.ahrq.gov/Downloads/Modules/PQI/V60-ICD10/TechSpecs/PQI_90_Prevention_Quality_Overall_Composite.pdf

Data Collection Methodology: http://oshpd.ca.gov/HID/MIRCal/ManualsGuides.html

Indicator Source Changes: Updated AHRQ Quality Indicator (QI) Software; Version 6.01 (released September 2016) for 2016 data; 5.0 (released March 2015) for 2005-2015

1Preventable Hospitalization in California: Statewide and County Trends in Access to and Quality of Outpatient Care, Measured with Prevention Quality Indicators (PQIs), 1999-2008. Office of Statewide Health Planning and Development (2010)

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