Assessing the Health and Welfare of the HCBS Population

Table 14A: Outcome Indicators by County Supply of Health Care Providers

Table 14: Outcome Indicators by County and State Supply of Health Care Providers, 2005a

Select for Table 14B: Outcome Indicators by State Supply of Health Care Providers.

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Table 14A: Outcome Indicators by County Supply of Health Care Providers

HCBS Subpopulation Outcome Indicator Supply of Short-Term
Acute-Care Hospital
Beds per Capita
Supply of Nursing
Home Beds
(NFs and SNFs)
per 65+
Supply of Home Health
Agencies per Capita
Supply of ICFs-MR
per Capita
Supply of Psychiatric
Hospital Beds
per Capita
Underserved by Mental
Health Providers
Underserved by Primary
Care Providers
>Median ≤Median >Median ≤Median >Median ≤Median >Median ≤Median >Median ≤Median Yes No Yes No
National HCBS Population Short-Term Complications of Diabetes 293 287 316 279 276 305 275 336 279 321 280 327 285 329
Asthma or Chronic Obstructive Pulmonary Disease 3,958 3,761 4,770 3,472 3,976 3,822 3,570 4,796 3,611 4,607 3,755 4,320 3,806 4,441
Congestive Heart Failure 5,267 4,978 5,915 4,816 5,374 4,996 4,896 5,946 4,897 5,869 5,100 5,399 5,115 5,538
Composite: Potentially Preventable Infection 7,870 8,390 9,072 7,539 8,212 7,884 7,379 9,871 7,387 9,674 7,611 9,346 7,772 9,700
    Bacterial
    Pneumonia
4,768 5,251 5,721 4,539 5,052 4,811 4,488 6,135 4,451 6,112 4,694 5,627 4,758 5,956
    Urinary     Tract
    Infection
3,102 3,139 3,351 3,000 3,160 3,074 2,891 3,736 2,936 3,562 2,917 3,719 3,013 3,744
Infection Due to Device or Implant 768 749 851 719 771 754 740 823 751 789 728 865 760 773
Dehydration 1,941 1,854 2,226 1,762 1,903 1,921 1,774 2,297 1,785 2,234 1,818 2,204 1,859 2,246
Composite: ACSC Chronic Conditions 12,305 11,362 13,809 11,128 12,272 11,761 11,291 13,975 11,354 13,627 11,771 12,704 11,838 13,012
Composite: ACSC Acute Conditions 7,190 7,707 8,561 6,776 7,561 7,177 6,677 9,249 6,645 9,147 7,028 8,362 7,100 8,958
Composite: ACSC Overall 19,494 19,068 22,370 17,903 19,831 18,937 17,966 23,223 17,998 22,773 18,798 21,065 18,937 21,967
Pressure Ulcer 3,690 3,126 3,660 3,435 3,626 3,404 3,389 3,840 3,444 3,669 3,368 3,936 3,459 3,816
Injurious Falls 279 344 376 263 328 275 233 485 250 426 288 335 284 401
Dually Eligible HCBS Participants Short-Term Complications of Diabetes 233 233 252 225 216 249 221 265 227 249 222 267 228 267
Asthma or Chronic Obstructive Pulmonary Disease 4,158 4,050 5,076 3,660 4,262 4,001 3,732 5,135 3,765 4,993 3,959 4,614 4,005 4,832
Congestive Heart Failure 6,010 5,851 6,797 5,551 6,168 5,774 5,620 6,831 5,576 6,887 5,860 6,252 5,872 6,473
Composite: Potentially Preventable Infection 8,911 9,551 10,310 8,542 9,363 8,908 8,368 11,067 8,350 10,993 8,607 10,659 8,793 11,080
    Bacterial
    Pneumonia
5,356 5,956 6,496 5,093 5,742 5,386 5,040 6,877 4,977 6,950 5,267 6,404 5,350 6,759
    Urinary     Tract
    Infection
3,555 3,596 3,814 3,449 3,621 3,522 3,328 4,190 3,373 4,044 3,340 4,255 3,443 4,321
Infection Due to Device or Implant 758 709 806 711 747 737 730 773 737 754 718 812 743 735
Dehydration 2,197 2,102 2,477 2,015 2,146 2,183 2,018 2,550 2,019 2,524 2,063 2,477 2,103 2,543
Composite: ACSC Chronic Conditions 13,273 12,532 15,014 12,069 13,344 12,759 12,221 15,131 12,216 15,014 12,773 13,806 12,814 14,334
Composite: ACSC Acute Conditions 8,209 8,801 9,793 7,727 8,666 8,172 7,634 10,392 7,567 10,434 8,016 9,562 8,091 10,269
Composite: ACSC Overall 21,480 21,331 24,806 19,795 22,008 20,929 19,853 25,522 19,781 25,448 20,787 23,367 20,903 24,602
Pressure Ulcer 4,133 3,523 3,912 3,945 4,035 3,846 3,858 4,130 3,888 4,045 3,835 4,231 3,896 4,165
Injurious Falls 355 435 467 339 418 349 305 579 322 524 370 412 363 490
Medicaid-Only HCBS Participants Short-Term Complications of Diabetes 462 449 505 436 443 471 420 590 424 551 442 511 447 534
Asthma or Chronic Obstructive Pulmonary Disease 3,391 2,887 3,869 2,932 3,168 3,293 3,133 3,581 3,180 3,381 3,176 3,419 3,246 3,148
Congestive Heart Failure 3,165 2,343 3,329 2,709 3,140 2,695 2,948 2,769 3,007 2,633 2,947 2,783 2,975 2,441
Composite: Potentially Preventable Infection 4,924 4,885 5,442 4,661 4,972 4,857 4,720 5,578 4,707 5,482 4,787 5,319 4,882 5,126
    Bacterial
    Pneumonia
3,104 3,123 3,450 2,949 3,111 3,109 3,006 3,472 2,988 3,451 3,069 3,243 3,084 3,296
    Urinary     Tract
    Infection
1,820 1,762 1,993 1,711 1,861 1,748 1,714 2,106 1,719 2,031 1,718 2,076 1,798 1,830
Infection Due to Device or Implant 798 871 981 744 837 805 767 1,005 792 900 757 1,028 809 899
Dehydration 1,215 1,103 1,488 1,034 1,219 1,144 1,120 1,389 1,132 1,315 1,123 1,366 1,168 1,264
Composite: ACSC Chronic Conditions 9,566 7,827 10,276 8,428 9,255 8,811 8,792 9,824 8,953 9,218 8,930 9,325 9,079 8,630
Composite: ACSC Acute Conditions 4,306 4,406 4,949 4,047 4,449 4,235 4,104 5,144 4,079 5,054 4,230 4,685 4,298 4,613
Composite: ACSC Overall 13,871 12,234 15,225 12,474 13,703 13,045 12,895 14,968 13,031 14,271 13,160 14,009 13,377 13,240
Pressure Ulcer 2,435 1,929 2,922 1,971 2,477 2,094 2,127 2,798 2,206 2,474 2,044 3,033 2,223 2,658
Injurious Falls 63 72 107 46 76 57 42 148 48 115 56 97 60 107
I/DD Subpopulation Short-Term Complications of Diabetes 174 135 141 173 157 163 155 173 140 207 153 176 154 187
Asthma or Chronic Obstructive Pulmonary Disease 757 703 795 700 793 692 725 768 715 791 725 762 748 689
Congestive Heart Failure 729 553 668 664 697 640 671 653 681 630 682 632 683 587
Composite: Potentially Preventable Infection 4,319 4,340 4,622 4,136 4,524 4,166 4,236 4,545 4,189 4,655 4,135 4,731 4,302 4,440
    Bacterial
    Pneumonia
2,810 2,989 3,165 2,686 3,011 2,762 2,820 3,006 2,757 3,155 2,751 3,134 2,839 3,036
    Urinary     Tract
    Infection
1,509 1,351 1,457 1,450 1,513 1,403 1,417 1,540 1,433 1,501 1,384 1,597 1,463 1,404
Infection Due to Device or Implant 329 282 319 308 352 280 309 320 322 290 318 301 322 268
Dehydration 723 642 757 653 754 646 665 765 665 764 682 719 695 691
Composite: ACSC Chronic Conditions 2,307 1,821 2,151 2,122 2,240 2,046 2,147 2,099 2,114 2,178 2,140 2,120 2,178 1,927
Composite: ACSC Acute Conditions 3,376 3,275 3,612 3,164 3,525 3,189 3,258 3,537 3,207 3,658 3,239 3,551 3,302 3,513
Composite: ACSC Overall 5,684 5,096 5,763 5,286 5,764 5,235 5,405 5,636 5,321 5,836 5,379 5,671 5,480 5,440
Pressure Ulcer 1,524 1,248 1,380 1,455 1,569 1,307 1,405 1,474 1,405 1,474 1,390 1,498 1,464 1,246
Injurious Falls 74 70 93 59 82 65 60 104 69 81 67 84 71 78
SMI Subpopulation Short-Term Complications of Diabetes 503 534 515 511 494 526 492 572 490 578 501 541 484 666
Asthma or Chronic Obstructive Pulmonary Disease 5,142 4,793 5,426 4,788 5,360 4,785 4,718 5,969 4,913 5,387 4,982 5,162 5,022 5,096
Congestive Heart Failure 3,550 3,172 3,622 3,315 3,790 3,162 3,353 3,671 3,365 3,632 3,452 3,385 3,467 3,242
Composite: Potentially Preventable Infection 7,067 7,908 7,887 6,978 7,844 6,936 6,901 8,593 7,057 8,120 6,918 8,342 7,194 8,069
    Bacterial
    Pneumonia
4,482 5,172 5,165 4,403 5,024 4,447 4,412 5,539 4,512 5,234 4,443 5,323 4,619 5,119
    Urinary     Tract
    Infection
2,585 2,737 2,722 2,575 2,820 2,489 2,490 3,054 2,545 2,886 2,475 3,019 2,574 2,951
Infection Due to Device or Implant 728 801 857 684 852 674 716 853 731 808 708 857 755 729
Dehydration 1,983 2,020 2,176 1,881 2,142 1,882 1,925 2,199 1,959 2,098 1,953 2,097 2,001 1,956
Composite: ACSC Chronic Conditions 12,173 10,907 12,245 11,489 12,633 11,131 11,354 13,044 11,629 12,222 11,787 11,762 11,814 11,590
Composite: ACSC Acute Conditions 6,772 7,571 7,724 6,579 7,586 6,588 6,578 8,327 6,718 7,900 6,698 7,815 6,895 7,705
Composite: ACSC Overall 18,943 18,477 19,969 18,066 20,218 17,718 17,931 21,371 18,346 20,122 18,484 19,577 18,708 19,295
Pressure Ulcer 2,744 2,615 2,612 2,762 2,893 2,560 2,585 3,058 2,718 2,663 2,615 2,925 2,716 2,636
Injurious Falls 228 282 305 207 280 218 200 379 220 317 245 246 240 272
HCBS Population Ages 18-64 Without I/DD or SMI Short-Term Complications of Diabetes 626 634 674 607 612 645 575 784 599 696 601 720 621 682
Asthma or Chronic Obstructive Pulmonary Disease 5,026 4,600 6,140 4,282 4,735 5,034 4,551 5,856 4,642 5,439 4,683 5,572 4,783 5,609
Congestive Heart Failure 5,426 4,387 5,766 4,759 5,240 4,941 5,040 5,224 5,128 4,995 4,972 5,474 5,062 5,259
Composite: Potentially Preventable Infection 7,005 7,150 8,032 6,578 7,030 7,074 6,504 8,629 6,646 7,966 6,692 8,256 6,836 8,551
    Bacterial
    Pneumonia
4,003 4,057 4,626 3,728 3,999 4,042 3,732 4,851 3,756 4,616 3,891 4,455 3,895 4,891
    Urinary     Tract
    Infection
3,002 3,093 3,406 2,850 3,031 3,032 2,772 3,779 2,890 3,350 2,801 3,802 2,941 3,660
Infection Due to Device or Implant 1,745 1,744 1,961 1,640 1,665 1,821 1,670 1,960 1,768 1,691 1,627 2,140 1,705 2,017
Dehydration 1,797 1,658 2,150 1,559 1,725 1,778 1,646 2,058 1,693 1,885 1,645 2,110 1,686 2,211
Composite: ACSC Chronic Conditions 15,403 13,472 17,195 13,604 14,734 14,813 14,046 16,871 14,378 15,665 14,225 16,612 14,548 16,343
Composite: ACSC Acute Conditions 5,973 6,362 7,352 5,494 6,201 6,002 5,524 7,756 5,542 7,355 5,817 7,047 5,872 7,672
Composite: ACSC Overall 21,374 19,834 24,546 19,096 20,933 20,815 19,569 24,626 19,919 23,018 20,040 23,657 20,419 24,013
Pressure Ulcer 5,097 4,484 6,080 4,325 5,212 4,596 4,566 5,852 4,770 5,184 4,425 6,478 4,695 6,297
Injurious Falls 141 129 184 115 165 110 106 226 114 189 128 169 128 199
HCBS Population Age 65+ Short-Term Complications of Diabetes 138 128 155 127 110 157 127 156 140 121 129 155 132 154
Asthma or Chronic Obstructive Pulmonary Disease 4,780 5,026 6,592 4,169 4,907 4,810 4,325 6,380 4,380 6,115 4,494 6,210 4,626 6,501
Congestive Heart Failure 7,816 8,372 10,422 7,024 8,096 7,888 7,316 9,914 7,330 9,727 7,521 9,729 7,697 10,062
Composite: Potentially Preventable Infection 10,664 12,232 13,917 10,048 11,168 11,123 10,006 14,418 9,976 14,242 10,181 14,749 10,549 15,411
    Bacterial
    Pneumonia
6,421 7,643 8,797 6,004 6,881 6,718 6,020 9,026 5,941 9,060 6,250 8,839 6,438 9,359
    Urinary     Tract
    Infection
4,243 4,589 5,119 4,044 4,287 4,405 3,986 5,393 4,035 5,181 3,932 5,910 4,111 6,052
Infection Due to Device or Implant 523 499 598 484 512 520 506 544 500 559 492 606 517 511
Dehydration 2,663 2,744 3,416 2,400 2,584 2,782 2,436 3,412 2,442 3,340 2,452 3,571 2,558 3,619
Composite: ACSC Chronic Conditions 15,810 16,206 20,592 14,089 15,953 15,913 14,617 19,711 14,703 19,190 15,052 19,222 15,354 20,067
Composite: ACSC Acute Conditions 10,122 11,642 13,619 9,391 10,630 10,552 9,417 13,956 9,358 13,852 9,754 13,711 10,017 14,681
Composite: ACSC Overall 25,931 27,847 34,209 23,478 26,582 26,462 24,033 33,666 24,058 33,041 24,805 32,931 25,369 34,746
Pressure Ulcer 4,401 3,740 4,283 4,164 4,081 4,303 4,106 4,462 4,146 4,335 4,009 4,906 4,104 4,872
Injurious Falls 468 649 729 442 560 490 401 874 425 784 486 662 486 793
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Notes: 

ACSC = ambulatory care-sensitive condition; HCBS = home and community-based services; I/DD = intellectual and development disabilities; SMI = serious mental illness; NF = nursing facility; SNF = skilled nursing facility; ICFs-MR = intermediate care facilities for the mentally retarded.

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.

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Page last reviewed December 2012
Internet Citation: Table 14A: Outcome Indicators by County Supply of Health Care Providers. December 2012. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/long-term-care/resources/hcbs/hcbsfindings/hcbsfindtab14.html