Agency News and Notes

Potentially avoidable hospitalizations high among Medicare and Medicaid patients

Americans who were eligible for coverage under both Medicare and Medicaid in 2008 were hospitalized for bed sores, asthma, and diabetes at more than twice the rate of other Medicare beneficiaries, according to the latest News and Numbers from the Agency for Healthcare Research and Quality (AHRQ). These "dual eligibles" also were 52 percent more likely than other Medicare patients to be hospitalized for urinary tract infections and more than a third more likely to be admitted for bacterial pneumonia and chronic obstructive pulmonary disease.

AHRQ's analysis of hospital stays of dual-eligible and other Medicare patients for these and three other conditions—congestive heart failure, dehydration, and falls—also found that:

• Dual-eligible patients accounted for roughly one of every three Medicare hospital stays primarily involving bed sores, asthma, and diabetes, and one of every four stays for urinary tract infection, chronic obstructive pulmonary disease, and bacterial pneumonia.
• Dual-eligible patients aged 65 to 74 years were two to four times more likely than other Medicare patients the same age to have potentially preventable hospitalizations for most of the conditions studied.
• Among the nine potentially preventable hospitalizations, stays for bed sores had the highest average hospital cost—$15,000—regardless of whether the Medicare patients had or did not have dual eligibility.

This AHRQ News and Numbers is based on statistics in Potentially Preventable Hospitalizations among Medicare-Medicaid Dual Eligibles, 2008 (http://www.hcup-us.ahrq.gov/reports/statbriefs/sb96.jsp). The statistics are drawn from HCUP State Inpatient Databases for 27 States. These States were selected for this analysis because they provided information to identify Medicare patients also covered by Medicaid.

For other information, or to speak with an AHRQ data expert, please contact Bob Isquith at Bob.Isquith@ahrq.hhs.gov or call (301) 427-1539.

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