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
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
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
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
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