Hospitalizations in the Program of All-Inclusive Care for the Elderly

Area of Science:

• Geriatric care
• Healthcare quality improvement
• Health services research

Background:

• The Program of All-Inclusive Care for the Elderly (PACE) is a Medicare and Medicaid managed care program.
• Understanding hospitalization and readmission patterns is crucial for evaluating elder care models.

Purpose of the Study:

• To quantify hospitalization, readmission, and potentially avoidable hospitalization (PAH) rates among PACE enrollees.
• To compare these rates with similar non-PACE populations.

Main Methods:

• Retrospective study design.
• Analysis of hospitalization, readmission (within 30 days), and PAH rates per 1,000 person-years.
• Comparison of rates between PACE enrollees and dually eligible aged or disabled waiver (ADW) enrollees.

Main Results:

• PACE enrollees had lower hospitalization rates (539/1,000) than ADW enrollees (962/1,000).
• PACE 30-day readmission rates (19.3%) were lower than the national average for dually eligible older enrollees (22.9%).
• PAH rates were significantly lower in PACE (100/1,000) compared to ADW enrollees (250/1,000).

Conclusions:

• PACE enrollees experience better outcomes regarding hospital utilization compared to similar populations.
• Significant variations in hospitalization rates across PACE sites highlight opportunities for implementing best practices and enhancing quality of care.