Potentially preventable hospitalizations among American Indian and Alaska Native adults, 2016-2021

Potentially preventable hospitalizations are inpatient admissions for a standard set of selected acute illnesses and chronic conditions that might have been avoided with preventive care or outpatient management. During 2010-2012, Alaska Native adults had higher rates of potentially preventable hospitalizations compared to other adults in Alaska. We evaluated potentially preventable hospitalizations among American Indian/Alaska Native (AI/AN) adults in the United States during 2016-2021.

We used hospital discharge data from the Indian Health Service National Patient Information Reporting System (NPIRS) to calculate and compare average annual age-adjusted rates of potentially preventable hospitalizations per 1000 AI/AN adults for two acute conditions (community-acquired pneumonia and urinary tract infection) and four chronic conditions (diabetes, heart failure, asthma/chronic obstructive pulmonary disease, and hypertension).

Of 310,889 hospitalizations among AI/AN adults, 40,400 (13 %) were defined as potentially preventable for an annual rate of 7.6 per 1000 persons. Rates were stable during 2016-2019 (8.7 per 1000) but declined during 2020-2021 (5.9 per 1000), likely related to the COVID-19 pandemic. Older adults and rural residents had significantly higher rates of potentially preventable hospitalizations across all six conditions assessed, with community-acquired pneumonia having the highest hospitalization rate among adults aged ≥65 years (5.2 per 1000).

Targeted preventive care and appropriate outpatient management for AI/AN elders living in rural areas might help improve health and reduce medical costs through decreased hospitalizations. Vaccination against respiratory infections could have the greatest impact in reducing preventable hospitalizations among AI/AN adults.