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Variation over time in preventable hospitalization rates across counties
Walton Sumner1, Michael D Hagen
1Department of Internal Medicine and General Medical Sciences, Washington University School of Medicine, St. Louis, MO, USA. wsumner@dom.wustl.edu
Journal of the American Board of Family Medicine : JABFM
|November 17, 2011
Summary
Prevention quality indicators (PQIs) for diabetes and asthma showed stable trends over time across Kentucky counties. This stability suggests consistent healthcare processes and allows for targeted quality improvement efforts to address varying health needs.
Area of Science:
- Health Services Research
- Quality Improvement Science
- Public Health
Background:
- The Agency for Health Care Research and Quality developed 14 prevention quality indicators (PQIs).
- Four PQIs focus on preventable diabetes hospitalizations, and one on asthma.
- County-level PQI variation is known, but temporal variation is undescribed.
Purpose of the Study:
- To describe the variation of prevention quality indicators (PQIs) over time across Kentucky counties.
- To assess the stability and correlation of PQIs related to diabetes and asthma.
Main Methods:
- Utilized Kentucky Cabinet for Health and Family Services data from 2006-2008.
- Analyzed county-level PQI data for temporal variation and inter-measure correlations.
- Focused on PQIs for diabetes complications and asthma.
Main Results:
- PQI rates exhibited significant variation (up to 10-fold) between counties.
- Repeated measures of several PQIs demonstrated high correlation, indicating temporal stability.
- Specific PQIs like emergent diabetes complications (PQI01) showed poor correlation with others.
Conclusions:
- County-level PQI measures demonstrated stability over the study period.
- This stability suggests non-random healthcare processes and provides a basis for targeted quality improvement.
- While needs vary by county, stable indicators allow for focused interventions.
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