Tracking Potentially Avoidable Hospitalizations in Tennessee

Tennesseans spend more on hospital care than any other medical treatment, with their hospital costs accounting for more than a third of all dollars spent on health care in 2007. According to researchers at the Fogelman College’s Center for Healthcare Economics, about 17% of these hospitalizations in Tennessee could have been avoided with adequate primary care, saving an estimated $491 million (10% of costs for all hospitalizations). The majority of PAHs are for chronic conditions (59% of total hospitalizations).

Considerable variations in potentially avoidable hospitalizations exist among Tennesseans of different gender, age, and race groups. Overall, women have 2,327 PAHs per 100,000 adults, 609 more potentially avoidable hospitalizations than men, or 1.4 times as many. For chronic conditions, the rates are closer—women have 1.2 times as many PAHs as men. Most of the difference, however, comes from acute conditions—women have 377 more acute PAHs per 100,000 than men, or 1.6 times as many.

The Issue Brief, “Potentially Avoidable Hospitalizations,” was written by Rebecca Pope, a Ph.D. student at the Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, and Professor Cyril Chang. The report is downloadable at: http://www.memphis.edu/mlche/pubs.php.

Understanding Non-Urgent Use of Hospitals’ Emergency Departments

In 2004, more than two million people visited the emergency departments of Tennessee hospitals. According to researchers at the Fogelman College’s Center for Healthcare Economics, of those two million visits, more than half are estimated to have been non-urgent situations.

Excessive use of the emergency department for non-urgent care places financial and logistical burdens on hospitals. It contributes to overcrowding, increased emergency wait times and potentially avoidable costs. Some reports indicate that non-urgent use of emergency services also compromises patient safety, adversely affecting the ability of staff to provide timely response.

Among the findings in a study presented by the Center for Healthcare Economics was that – among the different age groups – children under five years of age had the highest rate of non-urgent use at 66.9%. Lower income patients were also found to be more likely use emergency department services, which is consistent with findings in other states such as New Jersey, Utah and Texas.

Of the total billable emergency charges in Tennessee, which amounted to more than $2 million, nearly half (46.1%) are estimated to be charges incurred by non-urgent visits.

Further research is needed into the reasons for non-urgent use, to allow hospitals and others to target causes. Effective educational campaigns are needed to inform health care users of the resources available to them.

Research for this report was carried out at the Center for Healthcare Economics by Peter Miller (Research Associate of the Center), Rebecca Pope and Cyril Chang, the Center Director.