Association Of A Regional Health Improvement Collaborative With Ambulatory Care-Sensitive Hospitalizations

Area of Science:

• Health Services Research
• Quality Improvement Science
• Public Health Interventions

Background:

• Regional health improvement collaboratives are widespread but their impact on hospitalizations and costs is not well understood.
• Primary care-led initiatives aim to enhance healthcare quality across regions.
• Ambulatory care-sensitive conditions (ACSCs) are indicators of primary care access and quality.

Purpose of the Study:

• To quantify the association between a primary care-led regional health improvement collaborative and hospitalization rates for ACSCs.
• To evaluate the impact of the Better Health Partnership on avoidable hospitalizations and associated costs in Cuyahoga County, Ohio.

Main Methods:

• A difference-in-differences analysis was employed to compare hospitalization rates before and after the collaborative's establishment.
• Hospitalization data for ACSCs in Cuyahoga County were compared to six Ohio comparator counties.
• The study period spanned from 2003-2008 (pre-intervention) and 2009-2014 (post-intervention).

Main Results:

• Cuyahoga County experienced significantly greater declines in ACSC hospitalization rates compared to comparator counties post-intervention.
• Reductions were observed in 2009-2011 (106 fewer per 100,000) and 2012-2014 (91 fewer per 100,000).
• An estimated 5,746 hospitalizations were averted between 2009-2014, resulting in nearly $40 million in cost savings.

Conclusions:

• The Better Health Partnership demonstrated a significant positive impact on reducing avoidable hospitalizations for targeted conditions.
• Primary care-led regional collaboratives utilizing positive deviance approaches can effectively improve health outcomes and reduce healthcare expenditures.
• Findings support the scalability and effectiveness of such collaboratives in enhancing primary care quality and efficiency.