Prevalence and Risk Factors for Potentially Avoidable Hospitalization of Medicaid Enrolled Nursing Home Residents

Publication Date: 6/1/2009

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Description:

Despite increasing concern about the frequency with which nursing home residents are transferred to hospitals for potentially avoidable, ambulatory caresensitive (ACS) conditions, the prevalence, risk factors and cost of these transfers among residents with and without serious mental illness (SMI) have not been investigated. Using a retrospective cohort design, this study examined the prevalence rates and risk factors of ACS hospitalizations for three groups of nursing home residents: 1) those with SMI, 2) those with Alzheimer disease or other dementia, 3) those with no diagnosed SMI or dementia. Additionally, we examined resident characteristics (i.e., age, race, diagnosis, and service use) and nursing home characteristics (e.g., ownership and quality of care) in relation to hospitalization rates for ACS conditions and time to ACS hospitalization. Finally, we examined potential disparities by exploring ACS hospitalization rates by race and mental health status and assessed costs associated with ACS hospitalizations.