Assessing the Health and Welfare of the HCBS Population

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

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

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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
		>Median	≤Median	>Median	≤Median	>Median	≤Median	>Median	≤Median	>Median	≤Median
National HCBS Population	Short-Term Complications of Diabetes	332	248	289	288	320	268	267	347	298	279
	Asthma or Chronic Obstructive Pulmonary Disease	4,773	3,039	4,590	3,155	4,485	3,462	3,765	4,143	4,729	3,007
	Congestive Heart Failure	5,732	4,583	5,600	4,672	5,643	4,798	5,008	5,474	5,801	4,465
	Composite: Potentially Preventable Infection	8,842	7,293	8,646	7,429	9,040	7,375	7,593	9,254	8,736	7,331
	Bacterial Pneumonia	5,485	4,423	5,417	4,451	5,598	4,494	4,690	5,597	5,456	4,405
	Urinary Tract Infection	3,358	2,869	3,229	2,978	3,441	2,881	2,903	3,657	3,279	2,926
	Infection Due to Device or Implant	802	715	820	694	846	697	737	810	819	694
	Dehydration	2,204	1,628	2,088	1,721	2,081	1,786	1,787	2,225	2,145	1,661
	Composite: ACSC Chronic Conditions	13,774	10,201	13,370	10,467	13,195	11,064	11,636	12,648	13,761	10,059
	Composite: ACSC Acute Conditions	8,183	6,565	8,085	6,602	8,331	6,689	6,980	8,327	8,116	6,561
	Composite: ACSC Overall	21,956	16,765	21,455	17,068	21,525	17,751	18,616	20,974	21,876	16,619
	Pressure Ulcer	3,799	3,199	3,745	3,230	3,858	3,242	3,356	3,845	3,772	3,200
	Injurious Falls	334	265	324	272	342	269	259	406	342	254
Dually Eligible HCBS Participants	Short-Term Complications of Diabetes	259	205	234	228	258	214	214	277	240	222
	Asthma or Chronic Obstructive Pulmonary Disease	5,044	3,212	4,824	3,376	4,857	3,586	3,941	4,479	4,922	3,247
	Congestive Heart Failure	6,659	5,212	6,476	5,350	6,537	5,490	5,749	6,313	6,636	5,165
	Composite: Potentially Preventable Infection	10,083	8,214	9,883	8,357	10,320	8,315	8,628	10,375	9,886	8,322
	Bacterial Pneumonia	6,228	4,939	6,174	4,957	6,398	5,004	5,284	6,273	6,156	4,950
	Urinary Tract Infection	3,854	3,275	3,709	3,400	3,922	3,311	3,344	4,102	3,731	3,372
	Infection Due to Device or Implant	782	692	793	679	820	680	722	769	783	687
	Dehydration	2,471	1,862	2,337	1,975	2,315	2,047	2,039	2,456	2,390	1,915
	Composite: ACSC Chronic Conditions	14,939	11,061	14,502	11,380	14,480	11,893	12,592	13,773	14,781	11,034
	Composite: ACSC Acute Conditions	9,399	7,435	9,300	7,477	9,579	7,586	7,995	9,377	9,240	7,500
	Composite: ACSC Overall	24,337	18,495	23,801	18,856	24,058	19,478	20,586	23,149	24,020	18,533
	Pressure Ulcer	4,200	3,634	4,114	3,703	4,179	3,726	3,809	4,158	4,107	3,701
	Injurious Falls	415	344	410	347	432	343	333	497	425	331
Medicaid-Only HCBS Participants	Short-Term Complications of Diabetes	548	371	444	464	503	423	413	589	472	437
	Asthma or Chronic Obstructive Pulmonary Disease	3,975	2,543	3,928	2,500	3,390	3,107	3,285	2,991	4,151	2,334
	Congestive Heart Failure	3,005	2,791	3,113	2,669	3,013	2,815	2,980	2,601	3,303	2,504
	Composite: Potentially Preventable Infection	5,192	4,666	5,136	4,689	5,274	4,684	4,762	5,415	5,292	4,556
	Bacterial Pneumonia	3,296	2,955	3,271	2,958	3,247	3,032	3,065	3,281	3,364	2,881
	Urinary Tract Infection	1,896	1,711	1,865	1,731	2,027	1,652	1,696	2,134	1,929	1,675
	Infection Due to Device or Implant	860	778	896	737	926	747	776	952	926	713
	Dehydration	1,416	963	1,381	970	1,393	1,038	1,099	1,432	1,415	951
	Composite: ACSC Chronic Conditions	10,346	7,749	10,159	7,774	9,415	8,688	9,024	8,796	10,707	7,330
	Composite: ACSC Acute Conditions	4,604	4,083	4,637	4,018	4,661	4,117	4,206	4,733	4,751	3,929
	Composite: ACSC Overall	14,949	11,832	14,796	11,790	14,076	12,804	13,229	13,529	15,458	11,258
	Pressure Ulcer	2,619	1,957	2,698	1,836	2,915	1,857	2,116	2,775	2,771	1,795
	Injurious Falls	96	38	80	50	77	58	57	95	93	39
I/DD Subpopulation	Short-Term Complications of Diabetes	164	144	144	169	145	163	153	159	137	180
	Asthma or Chronic Obstructive Pulmonary Disease	791	648	781	651	710	738	750	675	795	629
	Congestive Heart Failure	724	575	674	631	622	683	694	576	684	617
	Composite: Potentially Preventable Infection	4,522	4,295	4,707	4,030	4,485	4,363	4,500	4,248	4,787	3,906
	Bacterial Pneumonia	3,048	2,849	3,232	2,587	3,025	2,901	3,048	2,769	3,275	2,516
	Urinary Tract Infection	1,474	1,446	1,475	1,443	1,460	1,461	1,452	1,479	1,512	1,391
	Infection Due to Device or Implant	320	289	317	291	338	279	319	279	289	330
	Dehydration	752	636	756	622	739	666	697	703	743	638
	Composite: ACSC Chronic Conditions	2,285	1,867	2,155	2,012	2,029	2,146	2,184	1,907	2,172	1,985
	Composite: ACSC Acute Conditions	3,512	3,245	3,653	3,037	3,496	3,303	3,484	3,195	3,651	3,029
	Composite: ACSC Overall	5,797	5,112	5,808	5,048	5,526	5,450	5,668	5,101	5,823	5,014
	Pressure Ulcer	1,477	1,318	1,449	1,344	1,542	1,291	1,426	1,359	1,414	1,390
	Injurious Falls	86	56	84	58	78	68	63	92	86	54
SMI Subpopulation	Short-Term Complications of Diabetes	517	491	465	569	552	475	459	637	467	564
	Asthma or Chronic Obstructive Pulmonary Disease	5,367	4,459	5,298	4,513	5,560	4,602	4,789	5,540	5,496	4,234
	Congestive Heart Failure	3,522	3,221	3,411	3,373	3,842	3,097	3,332	3,576	3,523	3,208
	Composite: Potentially Preventable Infection	7,420	7,178	7,265	7,401	8,274	6,678	6,834	8,679	7,489	7,067
	Bacterial Pneumonia	4,800	4,571	4,812	4,539	5,287	4,313	4,456	5,399	4,975	4,304
	Urinary Tract Infection	2,621	2,607	2,453	2,862	2,987	2,365	2,378	3,280	2,514	2,764
	Infection Due to Device or Implant	711	783	742	740	919	622	706	839	738	745
	Dehydration	2,028	1,921	1,958	2,021	2,236	1,814	1,846	2,368	2,025	1,921
	Composite: ACSC Chronic Conditions	12,335	10,717	11,999	11,137	12,890	10,829	11,373	12,454	12,399	10,561
	Composite: ACSC Acute Conditions	7,096	6,863	7,055	6,912	7,933	6,371	6,608	8,093	7,253	6,623
	Composite: ACSC Overall	19,429	17,580	19,054	18,048	20,823	17,199	17,979	20,548	19,651	17,183
	Pressure Ulcer	2,713	2,642	2,609	2,796	3,040	2,444	2,503	3,188	2,637	2,751
	Injurious Falls	255	223	259	215	307	198	200	359	266	206
HCBS Population Ages 18-64 Without I/DD or SMI	Short-Term Complications of Diabetes	755	528	592	661	687	586	562	843	648	612
	Asthma or Chronic Obstructive Pulmonary Disease	6,463	3,649	6,075	3,820	5,323	4,577	4,792	5,215	6,550	3,528
	Congestive Heart Failure	5,746	4,576	5,671	4,568	5,267	4,965	5,085	5,119	6,075	4,285
	Composite: Potentially Preventable Infection	7,784	6,484	7,721	6,458	7,705	6,585	6,538	8,734	7,998	6,286
	Bacterial Pneumonia	4,505	3,642	4,407	3,675	4,327	3,801	3,810	4,709	4,579	3,566
	Urinary Tract Infection	3,280	2,842	3,314	2,783	3,378	2,784	2,728	4,025	3,419	2,720
	Infection Due to Device or Implant	1,962	1,572	1,957	1,552	1,804	1,701	1,648	2,056	2,092	1,459
	Dehydration	2,128	1,453	1,997	1,529	1,929	1,622	1,580	2,304	2,133	1,438
	Composite: ACSC Chronic Conditions	17,864	12,344	16,931	12,835	15,608	14,178	14,381	16,076	18,153	12,009
	Composite: ACSC Acute Conditions	6,870	5,499	6,942	5,346	6,776	5,613	5,703	7,399	7,110	5,278
	Composite: ACSC Overall	24,733	17,841	23,872	18,179	22,383	19,789	20,082	23,473	25,262	17,286
	Pressure Ulcer	5,536	4,402	5,759	4,127	5,865	4,198	4,511	6,164	5,868	4,109
	Injurious Falls	189	96	161	116	160	120	120	190	175	105
HCBS Population Age 65+	Short-Term Complications of Diabetes	167	108	159	114	150	126	123	170	171	102
	Asthma or Chronic Obstructive Pulmonary Disease	6,397	3,606	6,189	3,753	6,290	4,066	4,528	5,796	6,269	3,604
	Congestive Heart Failure	9,670	6,607	9,612	6,631	9,781	6,990	7,460	9,492	9,750	6,414
	Composite: Potentially Preventable Infection	13,254	9,483	12,911	9,732	13,723	9,775	10,276	13,812	12,792	9,731
	Bacterial     Pneumonia	8,143	5,747	8,056	5,800	8,543	5,878	6,280	8,411	7,933	5,832
	Urinary Tract     Infection	5,111	3,736	4,855	3,932	5,180	3,897	3,996	5,401	4,858	3,899
	Infection Due to Device or Implant	566	472	588	454	607	464	492	579	580	457
	Dehydration	3,315	2,183	3,164	2,296	3,138	2,441	2,478	3,309	3,205	2,232
	Composite: ACSC Chronic Conditions	19,734	12,826	19,554	12,920	19,483	13,958	14,978	18,641	19,765	12,520
	Composite: ACSC Acute Conditions	12,729	8,887	12,571	8,986	13,154	9,214	9,806	12,963	12,401	9,017
	Composite: ACSC Overall	32,461	21,712	32,124	21,904	32,636	23,170	24,783	31,601	32,163	21,535
	Pressure Ulcer	4,932	3,599	4,712	3,767	4,562	3,990	4,013	4,724	4,778	3,679
	Injurious Falls	608	453	613	448	665	445	444	756	630	428

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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