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Preventable hospitalizations: Medicare beneficiaries (per 1,000)
Kentucky - Montgomery

Measurement Period: 2012

County

80.9

State

National

59.3

HP 2020

  • 51.6
  • 159.6
  • 267.8
Discharge rate per 1,000 Medicare fee-for-service enrollees for ambulatory care sensitive conditions

Numerator

Number of hospitalizations for ambulatory care sensitive conditions by Medicare fee-for-service enrollees

Population

Number of Medicare fee-for-service enrollees

2012 - Dimensions

  • Total

    80.9
    69.9
    91.9
    0
    Comparison of 120 Counties
    80.9
      Low: 51.6             High: 267.8

Historical Data

  • Dimension2012201120102009
    Total80.9
    69.9 / 91.9
    83.4
    72.1 / 94.6
    79.2
    68.2 / 90.1
    77.8
    66.8 / 88.8
  • DSU - Data statistically unreliable.

Methodology

  • Numerator counts are based on ICD-9-CM diagnosis codes. Conditions: Convulsions (780.3x): Chronic Obstructive Pulmonary Disease (COPD) (491xx, 492xx, 494xx, 496xx, 466.0x: 466.0x only w/secondary dx 491xx, 492xx, 494xx, 496xx): Bacterial Pneumonia (481xx, 482.2x, 482.3x, 482.9x, 483xx, 485xx, 486xx: excl. secondary dx 282.6x): Asthma (493xx): Congestive Heart Failure (CHF) (428xx, 402.01, 402.11, 402.91, 518.4x: excl. sx 36.01, 36.02, 36.05, 36.1x,37.5x, or 37.7x): Hypertension (401.0x, 401.9x, 402.00, 402.10, 402.90: excl. sx 36.01, 36.02, 36.05, 36.1x,37.5x, or 37.7x): Angina (411.1x, 411.8x, 413xx: excl. sx 01-86.99): Cellulitis (681xx, 682xx, 683xx, 686xx: excl. sx 01-86.99, unless 86.0x is the first and only sx code): Diabetes (250.0x, 250.1x, 250.2x, 250.3x, 250.8x, 250.9x): Gastroenteritis (558.9x): Kidney/Urinary Infection (590xx, 599.0x, 599.9x): Dehydration (276.5x).
  • Surgical codes are usually excluded to ensure that the admission was for a medical condition.
  • Rates are adjusted for age, sex and race using the indirect method, using the U.S. Medicare population as the standard.

References

  • Basu J, Friedman B, Burstin H. Primary care, HMO enrollment, and hospitalization for ambulatory care sensitive conditions: A new approach. Med Care. 2002;40:1260-1269.
  • Ansari Z, Laditka JN, Laditka SB. Access to Health Care and hospitalization for ambulatory care sensitive conditions. Med Care Res Rev. 2006;63:719-741.

Data Source(s)

  • Dartmouth Atlas of Health Care

    Description The Dartmouth Atlas Project (DAP) began in 1993 as a study of health care markets in the United States, measuring variations in health care resources and their utilization by geographic areas: local hospital market areas, regional referral regions, and states. More recently, the research agenda has expanded to reporting on the resources and utilization among patients at specific hospitals. DAP research uses very large claims databases from the Medicare program and other sources to define where Americans seek care, what kind of care they receive, and to correlate increasing expenditures and the supply of health providers and services with health outcomes.

    MethodologyIndicators are created from Medicare claims and administrative data. The percentage of Medicare deaths occurring in a hospital was computed using “death in a hospital” (discharge status B in the Medicare Provider Analysis and Review (MEDPAR) file) as the numerator event. For the percentage of Medicare deaths who were admitted to an intensive care unit (ICU) in the last 6 months of life, the numerator event was “death in a hospital with admission to an ICU within 6 months of the death date, “ using MEDPAR files. Rates were age, sex, and race adjusted and were expressed as a percentage of deaths. Medicare decedents are identified by their ZIP code of residence. Total ICU days measures intensive care days (which includes medical, surgical, trauma, and burn care) and coronary care days to produce a total ICU days measure. Intermediate care or step-down units are also included.


 
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