Prevalence and Risk Factors for Potentially Avoidable Hospitalization of Medicaid-Enrolled Assisted Living Residents

Publication Date: 6/1/2010

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Description:

Avoidable hospitalizations place an enormous economic burden on an already overtaxed healthcare system. Hospitalizations for "ambulatory care sensitive" (ACS) conditions are considered avoidable, as these are physical health conditions that can be safely treated at lower level of care. Reducing avoidable hospitalizations for Medicaid-enrolled assisted living facility (ALF) residents represents an important opportunity for policy makers, payers and providers to reduce health care costs while improving quality of life and care for the residents involved. Despite increasing concern about the frequency with which individuals are transfers to hospitals for ambulatory care-sensitive (ACS) conditions, the prevalence, risk factors and cost of these transfers among assisted living residents have not been investigated. To better understand these issues, the authors examined risk factors, including demographic and diagnostic factors and expenditures for ACS hospitalization of Medicaid-enrolled ALF residents in Florida during FY 2003-2008. Additionally, this study compared demographic and diagnostic characteristics of Florida's Medicaid-enrolled assisted living and nursing home residents.