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Home Health & Hospice Week

Quality Improvement:

BATTLE AGAINST HOSPITALIZATION RATES VARIES BY REGION

Published on Mon Jan 28, 2008

Are your quality efforts hampered by being in one of the nation's least healthy states?

You may have to overcome many factors endemic to your state to reduce your rate of acute care hospitalizations.

Mississippi had almost twice as many preventable hospitalizations (110 per 1,000 Medicare enrollees) as Vermont (58 per 1,000), the latest American Health Rankings 2007 shows.

Hawaii had the fewest preventable hospitalizations (32.2 per 1,000 Medicare enrollees) while West Virginia had the most (114.4). Of the 25 states with the worst preventable hospitalization rates, 19 are east of the Mississippi River.

What is included: American Health Rankings is an annual state-by-state analysis that considers personal behavior, the community environment, quality of clinical care and community and policy decisions, the United Health Foundation explains in a release.

But those hospitalization rates can be misleading, warns Vince Caracci with Sta-Home Health Agency in Jackson, MS. They don't count flat hospitalizations, but rather divide the number of hospitalizations by the number of agency discharges to home, he tells Eli.

That makes HHAs with more discharges appear to have better "preventable" hospitalization rates, even if they are just discharging the same patients and readmitting them multiple times, he protests.

Some underlying data: Vermont tops the list of healthiest states while Mississippi is number 50, according to the report sponsored by the United Health Foundation, the Partnership for Prevention and the American Public Health Association. Mississippi spends twice as much per capita ($197 per person) as Vermont ($93 per person), the study reports.

In other comparisons between the two states, 31 percent of the population in Mississippi is obese, compared with 21 percent in Vermont. And twice as many people in Mississippi lack health insurance (21 percent) as in Vermont (10 percent).

Best and worst: Following top ranked Vermont as the healthiest state are Minnesota (2), Hawaii (3), New Hampshire (4) and Connecticut (5). Just above Mississippi at the bottom of the pack are Louisiana (49), Arkansas (48), Oklahoma (47) and Tennessee (46).

Resource: Information by state is at www.unitedhealthfoundation.org/ahr2007/index.html.

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