Health Index Priority: Decrease Preventable Hospitalizations

MaineHealth remains focused on high-quality, community-based primary care to manage chronic illnesses and improve care coordination as patients transition from one care setting to another.

For the Health Index initiative, the primary metric used to monitor preventable hospitalizations is the rate of admissions for 12 ambulatory care sensitive conditions. 

  • This metric reflects the efficiency of a population’s access to and use of primary care and the quality of the primary healthcare received.  For these 12 health conditions, high-quality community-based primary healthcare- that includes routine care for non-emergent acute or chronic conditions- often can avoid hospitalizations or more severe disease that require treatment within a hospital.

  • The three conditions with the highest admissions rates are heart failure, bacterial pneumonia, and chronic obstructive pulmonary disease.  The remaining nine conditions are angina (when no intervention is completed during the hospitalization), asthma, cellulitis, convulsions, dehydration, diabetes, gastroenteritis, hypertension, and kidney/urinary infections. 

Why does MaineHealth focus on decreasing preventable hospitalizations?

  • Avoiding preventable hospitalizations improves the quality of life for both patients and families.
  • Reducing unnecessary admissions reduces healthcare costs.

    Taking Action

    We support a variety of clinical, community and policy actions to help decrease preventable hospitalizations throughout the MaineHealth service area. Here are some of the ways that MaineHealth and our partners are responding: 

    Tracking Progress

    The Health Index initiative tracks and monitors a variety of data sources to measure progress being made to decrease preventable hospitalizations. In 2016, MaineHealth leaders set bold, aggressive targets for two of these measures as a way to challenge MaineHealth organizations to continue achieving positive steps toward the MaineHealth vision.

    Short-term measure and target:

    • As of September 30, 2018, the annual rate of hospitalization for COPD and Heart Failure for MaineHealth Accountable Care Organization’s Medicare Shared Savings Program will be equal to or less than 8.31 and 10.0 per 1,000 beneficiaries, respectively.

     

    Long-term measure and target:

    • In 2019, the most recent annual rate of hospitalizations for ambulatory care-sensitive conditions will be ≤30/1,000 Medicare enrollees.

     

    Hospitalization Rates for MaineHealth Accountable Care Organization (Short-term measure and target)

    PreventableHospitalizationsShortTermTarget 

    Within the MaineHealth Accountable Care Organization (MaineHealth ACO), the hospitalization rates for COPD/asthma were slightly higher in both 2016 and 2017 than in 2014 and 2015.  Similarly, the hospitalization rates for COPD/asthma were higher in 2017 than in 2014-2016.  However, for both conditions, the 2017 rates for beneficiaries were lower than the respective rates for enrollees in all Medicare Shared Savings Programs in the United States.

    Hospitalization Rates for Ambulatory Care-Sensitive Conditions (Long-term measure and target)

    PreventableHospitalizationsLongTermTarget

    One metric often used to monitor potentially preventable hospitalizations is the rate of admissions for ambulatory care-sensitive conditions (ACSC). For these health issues, high-quality outpatient care often can avoid hospitalizations, or early intervention can prevent complications or more severe disease.

    The ACSC hospitalization rate in the MaineHealth service area and for Maine overall increased from 2014 to 2015.  The service area's ACSC rate remains lower than the U.S. rate, although the U.S. rate decreased more from 2012 to 2015 than the service area rate did. 

    Interactive maps with county-level data

    Looking for more data about preventable hospitalizations? Visit the Health Index website to find data on hospitalizations, falls, and conditions that impact falls.
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