Trends In Avoidable Hospitalizations, 1980–1998

Kozak, Lola Jean; Hall, Margaret Jean; Owings, Maria

doi:10.1377/hlthaff.20.2.225

Cited by 82 publications

(72 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Perhaps most alarming, the uninsured are less likely to receive care for conditions that are judged by physicians to be serious and to require medical attention (Baker, Shapiro, and Schur 2000). Consequently, the uninsured are more frequently hospitalized for conditions that are potentially avoidable (Kozak, Hall, and Owings 2001;Weissman, Gatsonis, and Epstein 1992).…”

Section: The Consequences Of Being Uninsuredmentioning

confidence: 99%

Unhealthy and uninsured: Exploring racial differences in health and health insurance coverage using a life table approach

2010

View full text Add to dashboard Cite

Millions of people in the United 2002a;Osteen et al. 1994;Roetzheim et al. 1999). Being uninsured also poses serious fi nancial threats to Americans, with millions carrying a large burden of debt from medical expenses ( Himmelstein et al. 2005). Although public programs-such as Medicaid and the State Children's Health Insurance Program (SCHIP)-provide health insurance to many who would otherwise not be able to afford coverage, millions are without health insurance.In this article, we argue that current research offers a limited description of health insurance coverage in the United States, especially with respect to racial disparities. More specifi cally, the literature to date does not give a sense of the duration of exposure to being uninsured over a typical lifetime, nor does it address the joint risk of being uninsured and being unhealthy. Yet, having an estimate of the duration of time that individuals typically live with these risks is essential in assessing the magnitude of the insurance-related challenges facing the United States. Moreover, having durational measures of the joint risk of being uninsured and in different health states is particularly important when examining disparities between whites and blacks because blacks are not only more likely to be uninsured but also more likely to experience adverse health events. In this study, we use a life table approach to examine racial differences in health insurance coverage in the United States by calculating health-and insurance-specifi c life expectancies for whites and blacks. These measures capture the duration of exposure to different insurance and health states during a typical lifetime. In the absence of individual data on lifetime insurance coverage, life table analysis is a valuable tool that enables us to simulate life course experiences with health insurance coverage and health. By creating measures with a focus on the lifetime exposure to the joint risks of being uninsured and less healthy, we hope not only to provide a better understanding of issues related to health insurance coverage in the United States but also to elucidate racial disparities in the current U.S. health care system. Specifi cally, we address three important questions. First, how does the proportion of time spent in different health and insurance states over the course of one year differ by age and race? Second, given current age-specifi c mortality, subjective health, and health insurance rates in the United States, how many years can individuals expect to live with different types of insurance coverage and in different health states over a typical lifetime? Third, how large are the differences between blacks and whites in the expected number of years lived in different health-specifi c insurance states? BACKGROUND

show abstract

Section: The Consequences Of Being Uninsuredmentioning

confidence: 99%

Unhealthy and uninsured: Exploring racial differences in health and health insurance coverage using a life table approach

2010

View full text Add to dashboard Cite

show abstract

“…These hospitalizations can also be due to unnecessary or arbitrary practices. These hospitalizations can be seen in all age groups (2).…”

Section: Definitionmentioning

confidence: 85%

Preventable Hospitalizations in Older Adults: A Dream or Reality?

Naharci¹

2017

Istanbul Med J

View full text Add to dashboard Cite

An 84-year-old male patient applied to a primary care clinic with the complaint of left hip pain. The patient was diagnosed with myalgia and was given nonsteroidal anti-inflammatory drug (NSAID) (dexketoprofen) and muscle relaxant (feniramidol). After 1 week, the patient was brought to the emergency service due to anorexia and nausea by his relatives. He had been continuously using escitalopram 10 mg and rivastigmine patch 10 cm 2 for depression and dementia comorbidities. According to the laboratory investigations, it was seen that serum creatinine was 2.53 mg/dL (1.07 mg/dL 3 months ago), urea was 89 mg/dL (30 mg/dL 3 months ago), and potassium was 6.02 mg/dL (3.79 mg/dL 3 months ago). The patient was hospitalized with the diagnosis of acute renal failure and dehydration. Sample Case-2A 78-year-old female patient applied to the emergency care unit with the complaints of fever, cough, and respiratory disorder. It was found out that the patient had chronic obstructive pulmonary disease (COPD) and hypertension in her history. In physical examination, O 2 saturation was found to be 86%, arterial blood pressure was 95/55 mmHg, respiratory rate was 32/min, and there was a decrease in the respiratory sounds in the right lower lung zone. After the posteroanterior chest X-ray showed an infiltration zone on the right, the patient was hospitalized with the diagnosis of pneumonia and intravenous antibiotic therapy was started. On the second day of hospitalization, the patient had a complaint about chest pain. Clinical, laboratory, and electrocardiography (ECG) examinations were performed at the first evaluation. Following these examinations, cardiac catheterization was decided to be applied. A few days after cardiac catheterization, delirium developed in the patient with the symptoms of sudden loss of consciousness, attention disorder, and hyperactivity. The patient fell off the bed on the eighth day of hospitalization when she was in the delirium state and an intertrochanteric fracture developed in the right hip. The patient was transferred to the orthopedic clinic. After the preparation for surgery, a partial hip prosthesis replacement was performed in the patient. The Key Points• "Potentially preventable hospitalizations" are unnecessary hospitalizations despite the possibility of outpatient treatment.• Frail and old people with multiple chronic conditions are under high risk for hospitalization.• These hospitalizations put a heavy burden on the country's economy.• Heart failure, COPD, pneumonia, urinary infections, and dehydration are the most common causes.• To prevent these hospitalizations, interdisciplinary team work, discharge planning, support for drug use, and residential care are needed.Preventable Hospitalizations in Older Adults: A Dream or Reality?Preventable hospitalization is defined as hospitalization of patients in healthy conditions with the possibility of treatment by outpatient care. Preventable hospitalizations are seen commonly in patients aged 65 years or older. Congestive heart failure and chroni...

show abstract

“…These lead to high front-end deductibles that do not deter hospitalization but do limit economical coverage of prevention and early illness care, services that could actually reduce hospitalization. 14,30,41 6. Underfunded and confused Medicaid programs:…”

Section: Perverse Fiscal Incentives For the Insurance Industrymentioning

confidence: 99%

“…Reduce fragmentation and duplication of care by establishing a medical home that can also reduce expensive emergency department use and hospitalization. [38][39][40][41][42] iii. Increase the personal physician's knowledge of the patient with resulting greater efficiency in care, patient satisfaction, and compliance.…”

Section: Excessive Costs Threaten the National Economymentioning

confidence: 99%