PREVENTABLE HOSPITALIZATIONS www.dshs.state.tx.usph

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PREVENTABLE HOSPITALIZATIONSwww.dshs.state.tx.us/
ph

• Texas Indigent Health Care Association Conference
• Austin, TX
• November 20, 2008

Mike Gilliam, Jr., M.S.W., M.P.H. Assessment
Benchmarking Specialist Texas Department of State
Health Services
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• The purpose of this presentation is to provide
  information that can be used to
• Identify potential health care access problems
• Identify potential unmet health care needs
• Monitor the degree to which hospitalizations
  are avoided and dollars saved and
• Assist in developing strategies to improve
  health care and reduce costs.

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• Adult hospitalizations for the following
  conditions are called preventable
  hospitalizations, because if the individual had
  access to and cooperated with outpatient health
  care, hospitalization for these conditions could
  potentially have been prevented
• 1. Bacterial Pneumonia
• 2. Dehydration
• 3. Urinary Tract Infection
• 4. Perforated Appendix
• 5. Low Birth Weight
• 6. Angina (without Procedures)
• 7. Congestive Heart Failure
• 8. Hypertension (High Blood Pressure)
• 9. Adult Asthma
• 10. Chronic Obstructive Pulmonary Disease
• 11. Diabetes Short-Term Complications
• 12. Diabetes Long-Term Complications
• 13. Uncontrolled Diabetes and
• 14. Lower Extremity Amputation among Patients
  with Diabetes.

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• In 2005, adult residents of Texas received
  6,595,967,945 in hospital charges for these
  preventable hospitalization conditions
• 1. Bacterial Pneumonia
• 2. Dehydration
• 3. Urinary Tract Infection
• 4. Perforated Appendix
• 5. Low Birth Weight
• 6. Angina (without Procedures)
• 7. Congestive Heart Failure
• 8. Hypertension (High Blood Pressure)
• 9. Adult Asthma
• 10. Chronic Obstructive Pulmonary Disease
• 11. Diabetes Short-Term Complications
• 12. Diabetes Long-Term Complications
• 13. Uncontrolled Diabetes and
• 14. Lower Extremity Amputation among Patients
  with Diabetes.

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• Low rates of preventable hospitalizations can
  mean outpatient health care providers are doing a
  good job in diagnosing, educating and treating
  patients. Additionally, low rates can mean
  patients are participating in their care and
  adopting healthy lifestyle behaviors.

High rates of preventable hospitalizations can
mean there is room for improvement in outpatient
health care. For example, the need for
outpatient health care providers to diagnose,
educate and treat patients. Additionally, high
rates can mean there is room for improvement in
patients participating in their care and adopting
healthy lifestyle behaviors.
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• In 2005, adult Texas residents had fewer
  hospitalizations than was expected, based on
  national trends, for the following conditions
• ?Bacterial Pneumonia
• ?Dehydration
• ?Perforated Appendix
• ?Low Birth Weight
• ?Angina (without Procedures)
• ?Adult Asthma
• ?Chronic Obstructive Pulmonary Disease (COPD)
• ?Diabetes Short-Term Complications
• ?Uncontrolled Diabetes
• In 2005, adult Texas residents had more
  hospitalizations than was expected, based on
  national trends, for the following conditions
• ?Urinary Tract Infection
• ?Congestive Heart Failure
• ?Hypertension (High Blood Pressure)
• ?Diabetes Long-Term Complications
• ?Lower Extremity Amputation among Patients with
  Diabetes

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• In 2005, the following counties received at least
  5 times less the amount of preventable
  hospitalization charges, per adult county
  resident, as compared to the state average
  Burnet, Cass, Collin, Comal, Fort Bend, Hood,
  Kerr, McLennan, Travis, and Williamson.
• In 2005, the following counties received at least
  5 times more the amount of preventable
  hospitalization charges, per adult county
  resident, as compared to the state average
  Angelina, Atascosa, Bee, Brewster, Brown,
  Caldwell, Cameron, Camp, Ector, Fannin,
  Freestone, Galveston, Gray, Grayson, Gregg, Hill,
  Houston, Hunt, Jefferson, Jim Wells, Johnson,
  Kaufman, Kleberg, Lamar, Lampasas, Liberty,
  Limestone, Maverick, Nacogdoches, Orange, Polk,
  Red River, Rusk, San Augustine, Shelby, Trinity,
  Upshur, Victoria, Walker, and Webb.

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• Examples of Recent Activities to
• Reduce Preventable Hospitalizations
• Red River County
• In 2008, a county health coalition has focused on
  reducing Bacterial Pneumonia among senior
  citizens in Red River County. So far, in 2008,
  more than twice the amount of Bacterial Pneumonia
  Vaccinations have been given as compared to the
  total amount given from 2003 to 2007.
• Lamar County
• In 2008, two hospitals in Paris jointly funded a
  Coordinator of Community Health Services position
  at the Paris-Lamar County Health Department to
  coordinate health efforts in the county.

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• Preventable Hospitalizations Website
• www.dshs.state.tx.us/ph
• Maps of Preventable Hospitalizations in Texas
• County Profiles
• Rates of Preventable Hospitalizations
• Best Practice Clinical Interventions
• Policy Options
• Pediatric Preventable Hospitalizations (Spring
  2009)
• Mental Health Substance Abuse Preventable
  Hospitalizations (Summer 2009)
• 2008 Data (Summer 2009)
• Annual Data (Beginning in 2008)

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• DSHS Preventable Hospitalizations Project Team
• Wendy Andreades
• Stephanie Atkins
• Sylvia Cook
• Angie Estwick
• Jan Maberry
• Mike Messinger
• Glenna Stewart
• Mike Gilliam, Jr. (Project Lead)

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• Who can I contact if my county wants to work on
  reducing one or more of the preventable
  hospitalization conditions?
• Mike Gilliam, Jr.
• [phone] (Ext. 2708)
• mike.gilliam_at_dshs.state.tx.us