263774 Reducing Preventable Hospitalizations Through Regional Interdisciplinary Care for Seniors: The Arkansas Aging Initiative

Wednesday, October 31, 2012 : 9:06 AM - 9:18 AM

John B. Wayne, PhD , College of Public Health, Univ of Arkansas for Medical Sciences, Little Rock, AR
Glen Mays, PhD, MPH , College of Public Health, University of Kentucky, Lexington, KY
Claudia Beverly, PhD, RN, FAAN , Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, AR
Robin McAtee, PhD, RN, FACHE , Donald W. Reynolds Institute on Aging, University of Arkansas for Medical Sciences, Little Rock, AR
The Arkansas Aging Initiative (AAI) began in 2001 to improve health outcomes of older adults in rural and underserved areas by expanding access to interdisciplinary geriatrician-led clinical care and innovative community health education programs using a regional delivery model and partnerships with community hospitals. This study examined the impact of the AAI on potentially avoidable hospital admissions measured by AHRQ's Prevention Quality Indicators (PQIs). The study used a quasi-experimental, difference-in-difference design that compared patients served by participating AAI physicians to those of non-AAI physicians, before-and-after implementation of the AAI. The project utilized data from the Arkansas Hospital Discharge Data System for the years 2001-10. There were 1,621,766 hospitalizations among patients age 65 or older who resided in the AAI service areas studied. Controlling for gender, ethnicity, and age, AAI participation was associated a reduced overall rate of potentially avoidable admissions (p<0.001). Models for each of the PQI measures showed statistically-significant reductions in admissions for: COPD, Hypertension, CHF, Bacterial Pneumonia, and UTI. AAI partnered hospitals had improvements in specific PQIs compared to other hospitals in their service area. Preventable hospitalizations results in less cost to Medicare and are thought to result in better health care resulting in a better quality of life. While all potential variables affecting the outcomes could not be controlled for, the results suggest that the AAI has had a significant impact on reducing avoidable hospital admission for older adults in the areas they served. Other results provide insight into additional research needed to elucidate program effects.

Learning Areas:
Chronic disease management and prevention
Conduct evaluation related to programs, research, and other areas of practice

Learning Objectives:
Participants will be able to: 1. Describe an Aging Initiative associated a reduced overall rate of avoidable admissions; 2. Discuss the specific avoidable admissions influenced most by the aging initiative; 3. Understand the positive impacts within partnered hospitals.

Keywords: Aging, Evaluation

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Professor Wayne has been a fulltime faculty member since 1976. He Chaired the Health Services Administration Department from 1997-2003 and the COPH Department of Health Policy and Management from 2001-2004. He teaches in the areas of health care finance, health economics, and management/leadership skills. Dr. Wayne's current research focuses on the effectiveness of public health systems; multidisciplinary approaches to improve services to children with neurodevelopmental disorders; rural health; and evaluation of health services delivery.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.