Assessing the Health and Welfare of the HCBS Population

Table 13E: SMI Subpopulation

Table 13: Outcome Indicators by Key Attributes of State Medicaid and Long-Term Care Environment, 2005a

Select for:

Outcome Indicator No Medically Needy Program More Restrictive Eligibility Criteria Less Restrictive Eligibility Criteria Nursing Home Level of Care Eligibility Criteria for HCBS Percentage of State LTC Funds Spent on HCBS
High Mid Low >Median ≤Median
Short-Term Complications of Diabetes 621 615 359 916 463 430 443 605
Asthma or Chronic Obstructive Pulmonary Disease 5,994 5,285 4,259 4,724 4,897 4,975 4,530 5,703
Congestive Heart Failure 4,359 3,531 2,829 3,346 3,399 3,725 2,948 4,100
Composite: Potentially Preventable Infection 8,987 8,470 5,551 8,556 7,780 7,044 6,372 8,804
    Bacterial Pneumonia 5,698 5,263 3,759 5,075 4,979 4,597 4,235 5,439
    Urinary Tract Infection 3,289 3,208 1,792 3,481 2,801 2,447 2,137 3,364
Infection Due to Device or Implant 966 853 540 836 842 780 610 947
Dehydration 2,382 2,360 1,473 2,354 2,228 1,783 1,629 2,539
Composite: ACSC Chronic Conditions 14,034 12,144 10,125 11,950 11,303 11,964 10,491 13,486
Composite: ACSC Acute Conditions 8,624 8,018 5,363 7,891 7,540 6,797 6,136 8,352
Composite: ACSC Overall 22,658 20,161 15,487 19,836 18,844 18,762 16,626 21,838
Pressure Ulcer 3,490 2,892 2,126 3,314 2,623 2,679 2,298 3,287
Injurious Falls 340 266 175 175 314 210 190 322

Notes: 

ACSC = ambulatory care-sensitive condition; HCBS = home and community-based services; I/DD = intellectual and development disabilities; SMI = serious mental illness; LTC = long-term care.

a. All outcome indicators expressed as potentially avoidable hospital stays per 100,000 persons in the HCBS population. HCBS population for outcome indicators excludes: individuals under age 18; people with only institutional use in a given quarter; people on managed care plans; and persons in the States of Arizona, Maine, Washington, and Wisconsin.

Dually eligible = dually eligible for Medicaid and Medicare. Eligibility for Medicare defined as inclusion in Medicare denominator file.

Medicaid only = part of Medicaid HCBS population but not enrolled in Medicare.

HCBS subpopulations of I/DD, SMI, Under 65 Without I/DD or SMI, and 65+ are defined as in the Appendix.

Median is defined as the value at which half of States are below and half of States are above.

Source for Outcome Indicators: Agency for Healthcare Research and Quality (AHRQ), Medicaid Analytic eXtract (MAX) data, and Medicare Provider Analysis and Review (MedPAR) data.

Sources for column heading data are described in the Appendix.

Return to Contents
Return to Document

Page last reviewed December 2012
Internet Citation: Table 13E: SMI Subpopulation. December 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/long-term-care/resources/hcbs/hcbsfindings/hcbsfindtab13e.html