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

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.