Assessing the Health and Welfare of the HCBS Population

Table 15: Outcome Indicators by County and State Demographics, 2005^a

Select for Table 15B: Outcome Indicators by State Demographics.

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HCBS Subpopulation	Outcome  Indicator	Percent Age 65+		Percent Age 85+		Percent White		Percent African American		Percent Hispanic
		>Median	≤Median	>Median	≤Median	>Median	≤Median	>Median	≤Median	>Median	≤Median
National HCBS Population	Short-Term Complications of Diabetes	305	287	300	288	291	291	303	239	262	402
	Asthma or Chronic Obstructive Pulmonary Disease	5,012	3,579	4,733	3,578	5,443	3,533	3,783	4,395	3,484	5,433
	Congestive Heart Failure	5,745	5,013	5,679	4,983	5,635	5,066	5,275	4,716	4,819	6,507
	Composite: Potentially Preventable Infection	9,562	7,608	9,130	7,625	10,003	7,580	7,841	8,928	7,425	10,339
	Bacterial Pneumonia	6,199	4,564	5,876	4,564	6,683	4,514	4,686	5,997	4,517	6,452
	Urinary Tract Infection	3,363	3,044	3,254	3,061	3,320	3,066	3,155	2,930	2,908	3,887
	Infection Due to Device or Implant	751	765	761	763	740	767	786	656	735	864
	Dehydration	2,202	1,831	2,196	1,806	2,064	1,877	1,946	1,761	1,774	2,433
	Composite: ACSC Chronic Conditions	13,709	11,519	13,355	11,489	13,817	11,578	12,078	11,652	11,119	15,311
	Composite: ACSC Acute Conditions	8,997	6,894	8,597	6,888	9,387	6,884	7,121	8,423	6,744	9,658
	Composite: ACSC Overall	22,706	18,412	21,951	18,376	23,203	18,460	19,198	20,074	17,863	24,967
	Pressure Ulcer	3,341	3,555	3,254	3,604	2,976	3,632	3,684	2,714	3,402	3,905
	Injurious Falls	429	263	406	260	468	261	269	440	259	455
Dually Eligible HCBS Participants	Short-Term Complications of Diabetes	232	234	230	235	241	232	242	197	216	297
	Asthma or Chronic Obstructive Pulmonary Disease	5,277	3,778	4,978	3,781	5,804	3,716	3,980	4,743	3,665	5,798
	Congestive Heart Failure	6,589	5,769	6,507	5,738	6,619	5,798	6,033	5,631	5,543	7,475
	Composite: Potentially Preventable Infection	10,766	8,628	10,299	8,649	11,359	8,578	8,863	10,236	8,418	11,690
	Bacterial Pneumonia	6,954	5,132	6,601	5,132	7,592	5,058	5,247	6,871	5,071	7,310
	Urinary Tract Infection	3,812	3,496	3,697	3,517	3,768	3,520	3,615	3,365	3,347	4,380
	Infection Due to Device or Implant	683	759	709	755	660	762	771	617	727	797
	Dehydration	2,460	2,078	2,447	2,054	2,307	2,132	2,208	1,984	2,016	2,717
	Composite: ACSC Chronic Conditions	14,793	12,505	14,438	12,469	15,098	12,531	13,054	12,934	12,099	16,443
	Composite: ACSC Acute Conditions	10,186	7,869	9,760	7,859	10,686	7,849	8,108	9,677	7,707	10,947
	Composite: ACSC Overall	24,978	20,372	24,196	20,327	25,783	20,379	21,161	22,609	19,805	27,388
	Pressure Ulcer	3,678	4,011	3,589	4,072	3,172	4,118	4,156	2,969	3,860	4,206
	Injurious Falls	520	339	493	336	568	336	345	539	334	554
Medicaid-Only HCBS Participants	Short-Term Complications of Diabetes	559	434	540	432	454	459	473	380	390	731
	Asthma or Chronic Obstructive Pulmonary Disease	4,088	3,032	3,893	3,024	4,262	3,020	3,231	3,245	2,973	4,290
	Congestive Heart Failure	2,806	2,932	2,851	2,926	2,412	3,011	3,145	1,699	2,768	3,476
	Composite: Potentially Preventable Infection	5,368	4,805	5,140	4,840	5,558	4,778	4,971	4,613	4,617	6,109
	Bacterial Pneumonia	3,569	3,002	3,400	3,018	3,704	2,987	3,109	3,115	2,949	3,764
	Urinary Tract Infection	1,799	1,803	1,739	1,822	1,854	1,791	1,862	1,498	1,668	2,345
	Infection Due to Device or Implant	985	782	938	783	1,001	783	827	785	758	1,072
	Dehydration	1,306	1,151	1,338	1,130	1,268	1,162	1,210	1,026	1,091	1,543
	Composite: ACSC Chronic Conditions	9,936	8,808	9,658	8,820	9,618	8,900	9,336	7,426	8,346	11,767
	Composite: ACSC Acute Conditions	4,856	4,215	4,625	4,246	5,133	4,172	4,347	4,287	4,020	5,622
	Composite: ACSC Overall	14,792	13,022	14,282	13,066	14,751	13,071	13,683	11,713	12,366	17,386
	Pressure Ulcer	2,167	2,303	2,110	2,330	2,332	2,266	2,356	1,874	2,109	2,960
	Injurious Falls	113	54	110	52	137	51	56	114	47	142
I/DD Subpopulation	Short-Term Complications of Diabetes	161	160	153	164	139	167	168	131	147	198
	Asthma or Chronic Obstructive Pulmonary Disease	844	702	795	711	799	716	757	664	696	861
	Congestive Heart Failure	684	660	628	683	609	685	715	487	635	757
	Composite: Potentially Preventable Infection	4,444	4,288	4,385	4,301	4,702	4,197	4,405	4,039	4,115	4,962
	Bacterial Pneumonia	3,079	2,807	3,051	2,793	3,345	2,711	2,869	2,894	2,724	3,324
	Urinary Tract Infection	1,365	1,481	1,334	1,507	1,357	1,486	1,537	1,145	1,391	1,638
	Infection Due to Device or Implant	281	323	293	321	258	331	331	245	316	300
	Dehydration	698	693	711	687	685	697	728	571	660	797
	Composite: ACSC Chronic Conditions	2,188	2,115	2,072	2,161	1,939	2,200	2,271	1,630	2,064	2,339
	Composite: ACSC Acute Conditions	3,483	3,293	3,410	3,308	3,570	3,260	3,396	3,134	3,156	3,890
	Composite: ACSC Overall	5,671	5,408	5,482	5,469	5,509	5,461	5,667	4,764	5,221	6,229
	Pressure Ulcer	1,184	1,504	1,154	1,549	1,112	1,533	1,544	990	1,399	1,503
	Injurious Falls	102	63	102	59	96	64	71	77	63	100
SMI Subpopulation	Short-Term Complications of Diabetes	587	491	525	507	507	514	539	384	475	641
	Asthma or Chronic Obstructive Pulmonary Disease	6,002	4,761	5,510	4,825	6,142	4,727	4,956	5,398	4,690	6,216
	Congestive Heart Failure	3,624	3,379	3,355	3,467	3,275	3,477	3,565	2,808	3,236	4,112
	Composite: Potentially Preventable Infection	8,167	7,092	7,778	7,132	8,724	6,942	7,231	7,786	6,858	8,943
	Bacterial Pneumonia	5,405	4,496	5,250	4,455	6,027	4,328	4,564	5,322	4,354	5,871
	Urinary Tract Infection	2,761	2,595	2,528	2,677	2,698	2,614	2,667	2,465	2,504	3,072
	Infection Due to Device or Implant	807	735	766	744	798	738	748	765	724	844
	Dehydration	2,107	1,963	2,103	1,948	1,977	1,999	2,044	1,760	1,905	2,301
	Composite: ACSC Chronic Conditions	12,973	11,444	11,986	11,689	12,288	11,640	12,023	10,632	11,159	13,914
	Composite: ACSC Acute Conditions	7,968	6,752	7,567	6,782	8,487	6,614	6,891	7,626	6,551	8,629
	Composite: ACSC Overall	20,938	18,196	19,552	18,470	20,776	18,252	18,913	18,258	17,709	22,543
	Pressure Ulcer	2,456	2,774	2,238	2,907	2,566	2,742	2,770	2,395	2,604	3,047
	Injurious Falls	345	217	327	209	331	221	232	308	213	354
HCBS Population Ages 18-64 Without I/DD or SMI	Short-Term Complications of Diabetes	655	621	638	625	647	625	652	528	536	970
	Asthma or Chronic Obstructive Pulmonary Disease	6,321	4,488	6,085	4,476	7,240	4,373	4,797	5,288	4,341	6,905
	Congestive Heart Failure	4,860	5,151	5,074	5,092	5,021	5,102	5,402	3,691	4,787	6,196
	Composite: Potentially Preventable Infection	8,223	6,726	7,857	6,775	8,878	6,653	6,994	7,313	6,521	9,012
	Bacterial Pneumonia	5,029	3,739	4,719	3,780	5,424	3,714	3,918	4,474	3,713	5,154
	Urinary Tract Infection	3,194	2,986	3,138	2,995	3,454	2,939	3,075	2,839	2,808	3,858
	Infection Due to Device or Implant	1,726	1,750	1,834	1,714	1,774	1,738	1,811	1,449	1,679	1,985
	Dehydration	1,944	1,698	2,024	1,658	1,991	1,700	1,785	1,607	1,644	2,150
	Composite: ACSC Chronic Conditions	16,180	14,382	16,171	14,292	17,321	14,217	15,080	13,419	13,548	19,300
	Composite: ACSC Acute Conditions	7,379	5,743	7,065	5,768	8,302	5,618	5,934	6,835	5,528	8,210
	Composite: ACSC Overall	23,559	20,123	23,234	20,059	25,623	19,833	21,013	20,253	19,075	27,506
	Pressure Ulcer	5,013	4,865	4,992	4,865	5,107	4,851	5,038	4,275	4,612	5,950
	Injurious Falls	213	116	218	109	230	117	121	210	108	244
HCBS Population Age 65+	Short-Term Complications of Diabetes	128	137	150	130	140	134	138	117	131	153
	Asthma or Chronic Obstructive Pulmonary Disease	6,631	4,386	6,351	4,333	8,055	4,261	4,597	6,170	4,244	7,485
	Congestive Heart Failure	9,780	7,512	9,745	7,372	10,942	7,437	7,864	8,610	7,231	11,238
	Composite: Potentially Preventable Infection	14,255	10,322	13,766	10,228	16,309	10,185	10,600	13,913	10,046	15,872
	Bacterial Pneumonia	9,235	6,151	8,810	6,092	10,966	6,021	6,278	9,428	6,061	9,954
	Urinary Tract Infection	5,021	4,171	4,956	4,137	5,344	4,164	4,322	4,485	3,984	5,918
	Infection Due to Device or Implant	512	517	527	512	512	517	528	453	496	603
	Dehydration	3,337	2,516	3,312	2,470	3,368	2,562	2,685	2,706	2,427	3,810
	Composite: ACSC Chronic Conditions	19,577	14,968	19,392	14,723	22,163	14,774	15,591	17,664	14,467	22,234
	Composite: ACSC Acute Conditions	13,889	9,716	13,414	9,601	15,785	9,623	10,019	13,484	9,503	15,261
	Composite: ACSC Overall	33,465	24,682	32,805	24,322	37,946	24,395	25,609	31,146	23,968	37,491
	Pressure Ulcer	4,049	4,237	4,031	4,256	3,540	4,320	4,407	3,134	4,076	4,721
	Injurious Falls	778	456	729	451	973	440	458	854	445	861

Notes: 

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

^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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