Hospital
Use Down but Avoidable Hospitalizations Increase
For Release
Monday, March 12, 2001
Contact: NCHS Press Office
(301) 458-4800
CDC Office of Media Relations (404) 639-3286
E-mail: paoquery@cdc.gov
Hospitalizations that
might have been avoided if patients had received timely and effective
ambulatory care increased by two thirds from 1980-98 according to results
from the Centers for Disease Control and Prevention's National Health Care
Survey, published in the March-April 2001 issue of Health Affairs.
The number of
hospitalizations for avoidable conditions rose from 2.2 million in 1980 to
3.7 million in 1998–from 5.9 percent to 11.5 of all hospitalizations.
Avoidable conditions, as determined by a panel of physicians, are those
for which timely and appropriate ambulatory care should prevent the
illness, control an acute episode or manage a chronic condition so that
hospitalization is generally unnecessary. However, the study recognized
that not all hospitalizations for each condition, depending upon severity
of the condition and other factors, could be avoided.
Hospitalization rates
increased for pneumonia, congestive heart failure, and cellulitis. In
addition, the survey indicated that hospitalization rates were also up for
ruptured appendix and potassium deficiency. However, rates were down for
asthma, perforated or bleeding ulcer and inflammation of the kidney.
Over the past two
decades, avoidable hospitalizations increased substantially for older
Americans. For those under age sixty-five avoidable hospitalizations
declined for white patients, but were up among black patients.
Regardless of source of
payment–Medicaid, Medicare, private insurance or self-pay–avoidable
hospitalizations increased from 1980 to 1998. The highest level for
hospitalizations (one in five) was for those 65 and over with Medicare and
Medicaid shown as the source of payment.
"Trends in
Avoidable Hospitalization, 1980-1988," is based on data from the
National Hospital Discharge Survey, one of the components of CDC’s National
Health Care Survey. Other components of the health care survey
obtain data from surveys of ambulatory care provided in physicians’
offices, hospital emergency and outpatient departments; nursing homes; and
hospice and home health agencies.
"Trend Data on
Medical Encounters: Tracking a Moving Target" uses the full range of
health care data to examine how medical care use has changed over the past
fifteen years. Since 1985, the general trends indicate that hospital
discharge rates decreased–down about 20 percent. However, nursing home
discharge rates rose more than any other segment of medical care,
reflecting the aging of the U.S. population. Between 1992 and 1996, home
health care expanded rapidly, but declined in 1998. The number of agencies
providing home and hospice care services doubled between 1992 and 1998.
The analysis shows
little change in the rate of visits to physicians, but there were notable
changes in the content of the visit. Patients were more likely to have
medicines prescribed, continued or provided during their visits. There
were increases in the prescribing of antidepressants and the study also
showed a drop in the use of antibiotics for children.
Nursing home residents
in 1997 were more disabled and received more services than they did in
1985. This may reflect the availability of alternative services such as
home health care which allows people to postpone or avoid a nursing home.
For more information on
the National Health Care Survey, conducted by CDC’s National Center for
Health Statistics and access to current and trend data, check the CDC
website.
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