Preventable Hospitalizations in United States
United States
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United States Value:
2,681
Discharges following hospitalization for ambulatory care sensitive conditions (PQI 90) per 100,000 Medicare beneficiaries ages 18 and older enrolled in the fee-for-service program
Preventable Hospitalizations in depth:
Additional Measures:
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Preventable Hospitalizations by State
Discharges following hospitalization for ambulatory care sensitive conditions (PQI 90) per 100,000 Medicare beneficiaries ages 18 and older enrolled in the fee-for-service program
Preventable Hospitalizations in
Data from U.S. HHS, Centers for Medicare & Medicaid Services, Office of Minority Health, Mapping Medicare Disparities Tool, 2021
<= 1,863
1,864 - 2,496
2,497 - 2,841
2,842 - 3,061
>= 3,062
Preventable Hospitalizations
- U.S. HHS, Centers for Medicare & Medicaid Services, Office of Minority Health, Mapping Medicare Disparities Tool, 2021
About Preventable Hospitalizations
US Value: 2,681
Top State(s): Idaho: 1,432
Bottom State(s): West Virginia: 3,874
Definition: Discharges following hospitalization for ambulatory care sensitive conditions (PQI 90) per 100,000 Medicare beneficiaries ages 18 and older enrolled in the fee-for-service program
Data Source and Years(s): U.S. HHS, Centers for Medicare & Medicaid Services, Office of Minority Health, Mapping Medicare Disparities Tool, 2021
Suggested Citation: America's Health Rankings analysis of U.S. HHS, Centers for Medicare & Medicaid Services, Office of Minority Health, Mapping Medicare Disparities Tool, United Health Foundation, AmericasHealthRankings.org, accessed 2024.
Some hospital admissions related to chronic conditions or acute illnesses are avoidable through adequate management and treatment in outpatient settings. The number of preventable hospitalizations reflects the overuse of the hospital as a primary source of care and provides insight into issues with accessibility and quality of outpatient primary care services.
Preventable hospitalizations place financial burdens on patients, insurance providers and hospitals. In 2017, $33.7 billion in hospital costs were attributable to preventable hospitalizations, the majority for chronic conditions such as heart failure, diabetes and chronic obstructive pulmonary disease.
Populations that experience higher rates of preventable hospitalizations include:
- Women compared with men.
- Black and American Indian/Alaska Native adults compared with Asian/Pacific Islander and white adults.
- Adults ages 65 and older, who have a rate of preventable hospitalization more than 12 times that of adults ages 18-44.
- Adults from lower-income communities compared with those from higher-income communities.
Continuous outpatient care for acute or chronic conditions can prevent complications, more severe disease and the need for hospitalization among the general population and among older adults in particular. A 2019 study found that Medicaid expansion was associated with a reduction in hospitalizations for conditions that could be treated in an outpatient setting.
Healthy People 2030 has numerous objectives related to hospitals and emergency services that focus on reducing preventable hospital stays and improving hospital care.
Kao, Yu-Hsiang, Wei-Ting Lin, Wan-Hsuan Chen, Shiao-Chi Wu, and Tung-Sung Tseng. “Continuity of Outpatient Care and Avoidable Hospitalization: A Systematic Review.” The American Journal of Managed Care 25, no. 4 (April 1, 2019): e126–34.
https://www.ajmc.com/view/continuity-of-outpatient-care-and-avoidable-hospitalization-a-systematic-review.
McDermott, Kimberly W., and H. Joanna Jiang. “Characteristics and Costs of Potentially Preventable Inpatient Stays, 2017.” Statistical Brief #259. Rockville, MD: Agency for Healthcare Research and Quality, June 2020. https://www.hcup-us.ahrq.gov/reports/statbriefs/sb259-Potentially-Preventable-Hospitalizations-2017.jsp.
Moy, Ernest, Eva Chang, and Marguerite Barrett. “Potentially Preventable Hospitalizations - United States, 2001-2009.” MMWR Supplements 62, no. 3 (November 22, 2013): 139–43. https://www.cdc.gov/mmwr/preview/mmwrhtml/su6203a23.htm.
Nyweide, David J., Denise L. Anthony, Julie P. W. Bynum, Robert L. Strawderman, William B. Weeks, Lawrence P. Casalino, and Elliott S. Fisher. “Continuity of Care and the Risk of Preventable Hospitalization in Older Adults.” JAMA Internal Medicine 173, no. 20 (November 11, 2013): 1879–85. https://doi.org/10.1001/jamainternmed.2013.10059.
Penchansky, Roy, and J. William Thomas. “The Concept of Access: Definition and Relationship to Consumer Satisfaction.” Medical Care 19, no. 2 (1981): 127–40. https://doi.org/10.1097/00005650-198102000-00001.
Rosano, Aldo, Christian Abo Loha, Roberto Falvo, Jouke van der Zee, Walter Ricciardi, Gabriella Guasticchi, and Antonio Giulio de Belvis. “The Relationship between Avoidable Hospitalization and Accessibility to Primary Care: A Systematic Review.” European Journal of Public Health 23, no. 3 (May 29, 2012): 356–60. https://doi.org/10.1093/eurpub/cks053.
Wen, Hefei, Kenton J. Johnston, Lindsay Allen, and Teresa M. Waters. “Medicaid Expansion Associated With Reductions In Preventable Hospitalizations.” Health Affairs 38, no. 11 (November 1, 2019): 1845–49. https://doi.org/10.1377/hlthaff.2019.00483.
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