AHRQ: Dual-eligible patients account for a third of Medicare hospital stays
Medicare beneficiaries dually eligible for Medicaid accounted for about one-third of all Medicare hospital stays in 2008, with a principal diagnosis of pressure ulcers (36 percent), asthma (32 percent) and diabetes (32 percent); and roughly one-quarter of stays for urinary tract infection (UTI), chronic obstructive pulmonary disease (COPD) and bacterial pneumonia, according to a Statistical Brief from the AHRQ’s Healthcare Cost and Utilization Project (HCUP), released Sept. 24.
Compared with other Medicare beneficiaries, dual eligibles were more than twice as likely to be hospitalized for pressure ulcers, asthma, and diabetes, 52 percent more likely for UTI, and over 30 percent more likely for COPD and bacterial pneumonia, according to H. Joanna Jiang, PhD, and colleagues.
The brief, titled “Potentially Preventable Hospitalizations Among Medicare-Medicaid Dual Eligibles,” listed the top three causes of potentially preventable hospitalizations for dual eligibles as:
Among the nine selected potentially preventable hospitalizations, stays for pressure ulcers had the highest average hospital cost per stay, at $15,000, irrespective of dual eligibility.
About half of dual eligible stays for diabetes and asthma were among patients ages 18 to 64. However, elderly patients age 85 and over accounted for one-third of stays for injurious falls and about one-quarter of stays for UTI, bacterial pneumonia and dehydration.
The greatest gap in potentially preventable hospitalizations between dual eligibles and non-dual eligibles occurred among those ages 65 to 74, for which the rate of stays for dual eligibles was nearly two to four times the rate of stays for non-dual eligibles, except for injurious falls.
Click here to see the Statistical Brief.
Compared with other Medicare beneficiaries, dual eligibles were more than twice as likely to be hospitalized for pressure ulcers, asthma, and diabetes, 52 percent more likely for UTI, and over 30 percent more likely for COPD and bacterial pneumonia, according to H. Joanna Jiang, PhD, and colleagues.
The brief, titled “Potentially Preventable Hospitalizations Among Medicare-Medicaid Dual Eligibles,” listed the top three causes of potentially preventable hospitalizations for dual eligibles as:
- Bacterial pneumonia (2,041 stays per 100,000 enrollees);
- Congestive heart failure (1,829 stays per 100,000 enrollees); and
- COPD (1,179 stays per 100,000 enrollees).
Among the nine selected potentially preventable hospitalizations, stays for pressure ulcers had the highest average hospital cost per stay, at $15,000, irrespective of dual eligibility.
About half of dual eligible stays for diabetes and asthma were among patients ages 18 to 64. However, elderly patients age 85 and over accounted for one-third of stays for injurious falls and about one-quarter of stays for UTI, bacterial pneumonia and dehydration.
The greatest gap in potentially preventable hospitalizations between dual eligibles and non-dual eligibles occurred among those ages 65 to 74, for which the rate of stays for dual eligibles was nearly two to four times the rate of stays for non-dual eligibles, except for injurious falls.
Click here to see the Statistical Brief.