The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #69824

Sheryl M Davies, MA¹, Patrick S. Romano, MD, MPH², Kathryn M. McDonald, MM¹, Jeffrey Geppert, JD³, Anne Elixhauser, PhD⁴, and Denise Remus, PhD, RN⁴. (1) Center for Primary Care and Outcomes Research, Stanford University, 117 Encina Commons, Stanford, CA 94305, 650-723-0820, davies@healthpolicy.stanford.edu, (2) Center for Health Services Research in Primary Care, University of California Davis, 4150 V Street; PSSB Suite 2400, Sacramento, CA 95817, (3) National Bureau of Economic Research, 30 Alta Road, Stanford, CA 94305-6019, (4) Center for Organization and Delivery Studies, Agency for Healthcare Research and Quality, 2101 East Jefferson St., Suite 605, Rockville, MD 20852

Geographic, ethnic, and socioeconomic disparities in access to quality health care have been established in the literature.^1-3 Lack of access to quality care, either due to local shortages of health resources, cultural or circumstantial barriers, or perceived lack of economic or physical access to care, may result in poor care for chronic illnesses and delays in treating acute illnesses. Avoidable hospitalizations may result. The AHRQ Prevention Quality Indicators (PQIs), developed under contract by the UC-Stanford Evidence-based Practice Center, based on prior work by Billings, Weissman and others, ^4-10 are designed to identify potentially preventable hospitalizations using routinely collected administrative data. The indicators span chronic (e.g., diabetes, CHF, asthma) and acute conditions (e.g., pneumonia, gastroenteritis), and represent conditions for which high hospitalization rates have been associated with poor access to quality care.^4-10 Rates vary widely at the county/SMSA level, but correlate highly across conditions. The indicators are being used or merit consideration as part of public health initiatives and surveillance programs, such as the National Quality Report and similar reports from state agencies, regional coalitions, provider networks, and Medicaid agencies. The PQIs may prove particularly useful to public health agencies and health plans wishing to understand access to care in geographically or contractually defined populations. Unusually high rates for multiple indicators may signal either poor access to, or poor quality of ambulatory care services. Unusually high rates may also identify opportunities for education and interventions to reduce health care costs by preventing unnecessary hospitalization in the areas of highest need.

Learning Objectives:

• Describe the link between potentially preventable hospitalizations and lack of access to quality care. Discuss the ability of administrative data to track potentially preventable hospitalizations. Apply indicators, such as the Prevention Quality indicators, to health plan or area inpatient administrative data to track access to quality health care.

Keywords: Access to Care, Quality

Related Web page: www.qualityindicators.ahrq.gov

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Agency for Healthcare Research and Quality
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Under contract with AHRQ to conduct support activities for the quality indicators. Contract ensures academic freedom.