New Jersey: Primary Care Treatment Could Prevent Hospitalization
The New Jersey Department of Health and Senior Services (DHSS) released a report today which shows, by county, the number of potentially preventable hospital admissions for illnesses that could be managed with effective primary care.
The Prevention Quality Indicators Report (PQIR) indicates the impact of preventive care for both acute and chronic illnesses, including high blood pressure, diabetes and congestive heart failure. For example, patients with diabetes may be hospitalized for diabetic complications if their conditions are not adequately monitored, or if they do not receive the patient education needed for appropriate self-management.
“Without treatment by a primary care provider, chronic health conditions get progressively worse and people end up in the emergency room,” said Health and Senior Service Commissioner Heather Howard. “The data in this report present the issues, but the solutions – like early detection of chronic disease and health education – rest within the community.”
The report found substantial variations in preventable hospital admission rates by county, which appear to reflect socio-economic differences among county populations. People in more affluent areas are more likely to avoid hospitalization for conditions that respond well to effective care from a primary physician. However, those in less affluent counties are much more likely to be hospitalized for the same conditions.
For example, three urban counties – Hudson, Essex and Camden – had the highest admission rates for treatment of high blood pressure. The Hudson rate was 111.1 admissions for every 100,000 hospital discharges, while the Essex and Camden rates were 94.1 and 85.5, respectively. The lowest hospitalization rates for high blood pressure were seen in Hunterdon (18.1 per 100,000) followed by Ocean (29.9) and Morris (30.8) counties.
For people with short-term complications of diabetes, hospital admission rates were highest in Atlantic, Essex and Cumberland counties, at 88.1, 81.7 and 76.1 per 100,000 discharges, respectively. Hunterdon, Morris and Bergen counties had the lowest rates (13.8, 19.2 and 21.5, respectively).
The Prevention Quality Indicators Report (PQIR) was developed with information on hospital inpatient discharge data, also known as uniform billing (UB) data. Department staff analyzed UB data for 2005 using a set of 14 Prevention Quality Indicators (PQIs) developed by the federal Agency for Healthcare Research and Quality. The report compares counties to state and national averages for these conditions.
By providing insight into the healthcare system outside the hospital setting, the report offers local health departments, healthcare agencies and hospitals with a science-based guideline for community health planning efforts.
This is the first release of PQI measures for New Jersey UB data. New York is the only other state in the nation to release a PQI report using inpatient discharge data.
The New Jersey PQI report is a follow up to the Inpatient Quality Indicators Report released by the Department in July 2007, which utilized UB data to assess hospital quality measures.