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Assessing the Health and Welfare of the HCBS Population

Table 16: Outcome Indicators by County and State Socioeconomic Status, 2005a

Table 16B: Outcome Indicators by State Socioeconomic Status

HCBS Subpopulation Outcome Indicator Median
Income
Percent in
Poverty
Supply of
Federally Qualified
Health Centers
per Capita
Percent of
People 65+ Living
Alone
Percent Female
Labor Force
Participation
>Median ≤Median >Median ≤Median >Median ≤Median >Median ≤Median >Median ≤Median
National HCBS Population Short-Term Complications of Diabetes 254 342 287 293 360 263 337 249 294 284
Asthma or Chronic Obstructive Pulmonary Disease 3,314 4,720 3,896 3,782 4,517 3,632 4,806 3,116 4,365 3,428
Congestive Heart Failure 4,446 6,193 5,180 4,999 5,554 4,979 5,681 4,693 5,493 4,815
Composite: Potentially Preventable Infection 6,854 9,857 7,993 8,134 8,839 7,742 8,652 7,537 8,765 7,390
    Bacterial Pneumonia 4,269 5,953 4,889 5,038 5,595 4,691 5,406 4,550 5,349 4,562
    Urinary Tract Infection 2,585 3,904 3,104 3,096 3,245 3,051 3,246 2,987 3,415 2,828
Infection Due to Device or Implant 687 864 737 807 827 731 803 718 785 731
Dehydration 1,576 2,409 1,870 1,990 2,129 1,821 2,105 1,741 2,222 1,624
Composite: ACSC Chronic Conditions 10,412 14,217 12,026 11,575 13,225 11,430 13,786 10,405 12,899 11,034
Composite: ACSC Acute Conditions 6,179 9,131 7,304 7,421 8,388 6,959 7,996 6,810 7,932 6,815
Composite: ACSC Overall 16,590 23,347 19,328 18,994 21,612 18,388 21,781 17,215 20,829 17,849
Pressure Ulcer 3,050 4,160 3,514 3,406 3,667 3,420 3,778 3,252 3,773 3,233
Injurious Falls 252 369 291 315 388 265 268 321 294 301
Dually Eligible HCBS Participants Short-Term Complications of Diabetes 207 267 222 256 288 210 260 208 236 227
Asthma or Chronic Obstructive Pulmonary Disease 3,425 5,079 4,120 4,007 4,895 3,795 5,023 3,351 4,534 3,690
Congestive Heart Failure 5,048 7,180 5,970 5,729 6,369 5,735 6,498 5,435 6,327 5,525
Composite: Potentially Preventable Infection 7,704 11,200 9,090 9,155 9,979 8,790 9,822 8,544 9,948 8,355
    Bacterial Pneumonia 4,757 6,746 5,517 5,659 6,342 5,269 6,124 5,107 6,030 5,130
    Urinary Tract Infection 2,947 4,455 3,573 3,497 3,637 3,522 3,698 3,438 3,918 3,225
Infection Due to Device or Implant 669 834 727 757 803 710 764 712 767 706
Dehydration 1,802 2,677 2,128 2,220 2,354 2,080 2,336 2,009 2,477 1,863
Composite: ACSC Chronic Conditions 11,171 15,518 13,032 12,611 14,354 12,392 14,758 11,462 13,923 12,015
Composite: ACSC Acute Conditions 6,990 10,438 8,363 8,406 9,512 7,960 9,129 7,779 9,077 7,745
Composite: ACSC Overall 18,160 25,955 21,393 21,016 23,865 20,351 23,885 19,240 22,997 19,760
Pressure Ulcer 3,478 4,542 4,009 3,629 3,918 3,900 4,115 3,739 4,175 3,663
Injurious Falls 327 453 373 390 485 339 330 416 368 387
Medicaid-Only HCBS Participants Short-Term Complications of Diabetes 382 581 471 408 582 411 557 370 471 441
Asthma or Chronic Obstructive Pulmonary Disease 3,011 3,576 3,258 3,103 3,359 3,169 4,189 2,427 3,848 2,706
Congestive Heart Failure 2,805 3,043 2,926 2,797 3,062 2,834 3,353 2,517 2,940 2,853
Composite: Potentially Preventable Infection 4,539 5,568 4,865 5,050 5,354 4,764 5,319 4,584 5,143 4,728
    Bacterial Pneumonia 2,940 3,422 3,098 3,163 3,308 3,050 3,360 2,917 3,266 2,993
    Urinary Tract Infection 1,599 2,146 1,766 1,887 2,046 1,714 1,959 1,667 1,877 1,734
Infection Due to Device or Implant 735 959 766 958 902 788 916 736 839 799
Dehydration 961 1,553 1,134 1,295 1,441 1,087 1,448 956 1,440 963
Composite: ACSC Chronic Conditions 8,345 10,065 9,158 8,447 9,773 8,700 11,017 7,309 9,769 8,326
Composite: ACSC Acute Conditions 3,968 4,959 4,286 4,448 4,950 4,118 4,768 3,972 4,429 4,247
Composite: ACSC Overall 12,312 15,022 13,443 12,894 14,722 12,817 15,784 11,280 14,196 12,573
Pressure Ulcer 1,883 2,943 2,104 2,733 2,898 2,056 2,817 1,824 2,546 2,044
Injurious Falls 45 101 57 88 94 56 91 44 68 63
I/DD Subpopulation Short-Term Complications of Diabetes 135 187 171 128 157 154 131 184 155 155
Asthma or Chronic Obstructive Pulmonary Disease 678 802 762 663 628 763 788 650 786 652
Congestive Heart Failure 573 788 743 505 640 662 661 650 707 593
Composite: Potentially Preventable Infection 4,200 4,766 4,607 4,093 4,211 4,498 4,694 4,088 4,583 4,218
    Bacterial Pneumonia 2,877 3,085 3,048 2,800 2,809 3,014 3,248 2,608 3,103 2,780
    Urinary Tract Infection 1,323 1,681 1,559 1,292 1,403 1,483 1,445 1,480 1,480 1,438
Infection Due to Device or Implant 269 366 331 262 296 310 290 325 296 318
Dehydration 607 846 737 634 738 684 722 672 741 648
Composite: ACSC Chronic Conditions 1,893 2,414 2,297 1,743 1,925 2,159 2,117 2,066 2,218 1,942
Composite: ACSC Acute Conditions 3,146 3,780 3,577 3,068 3,373 3,397 3,568 3,176 3,466 3,298
Composite: ACSC Overall 5,039 6,194 5,874 4,811 5,299 5,555 5,685 5,243 5,684 5,240
Pressure Ulcer 1,206 1,720 1,560 1,136 1,380 1,414 1,379 1,435 1,413 1,394
Injurious Falls 61 90 75 68 86 67 73 72 85 58
SMI Subpopulation Short-Term Complications of Diabetes 438 612 499 523 577 481 524 486 479 546
Asthma or Chronic Obstructive Pulmonary Disease 4,469 5,799 5,061 4,811 5,397 4,843 5,584 4,337 4,971 5,009
Congestive Heart Failure 2,921 4,142 3,580 2,959 3,552 3,342 3,561 3,217 3,273 3,578
Composite: Potentially Preventable Infection 6,330 8,871 7,119 7,794 7,917 7,110 7,467 7,157 7,411 7,182
    Bacterial Pneumonia 4,175 5,535 4,536 5,102 5,178 4,538 4,919 4,470 4,777 4,596
    Urinary Tract Infection 2,155 3,336 2,583 2,692 2,739 2,572 2,548 2,687 2,634 2,587
Infection Due to Device or Implant 664 862 693 855 842 706 723 761 664 854
Dehydration 1,674 2,469 1,957 2,045 2,193 1,910 1,973 1,994 2,038 1,902
Composite: ACSC Chronic Conditions 10,414 13,609 12,002 10,837 12,400 11,397 12,701 10,522 11,398 12,039
Composite: ACSC Acute Conditions 6,038 8,506 6,813 7,440 7,832 6,707 7,185 6,795 6,939 7,086
Composite: ACSC Overall 16,451 22,114 18,813 18,277 20,232 18,103 19,885 17,316 18,336 19,125
Pressure Ulcer 2,329 3,238 2,737 2,555 2,934 2,595 2,693 2,673 2,606 2,796
Injurious Falls 205 299 238 251 314 217 217 269 225 266
HCBS Population Aged 18-64 Without I/DD or SMI Short-Term Complications of Diabetes 557 731 626 635 812 549 793 511 616 636
Asthma or Chronic Obstructive Pulmonary Disease 4,552 5,378 4,804 5,155 5,484 4,637 6,760 3,570 6,079 4,108
Congestive Heart Failure 4,915 5,347 5,058 5,198 5,313 4,998 6,109 4,374 5,600 4,758
Composite: Potentially Preventable Infection 6,490 7,871 6,793 7,849 7,669 6,795 7,998 6,394 7,791 6,575
    Bacterial Pneumonia 3,794 4,350 3,898 4,397 4,376 3,871 4,601 3,614 4,384 3,785
    Urinary Tract Infection 2,696 3,520 2,896 3,452 3,293 2,924 3,397 2,780 3,407 2,790
Infection Due to Device or Implant 1,658 1,868 1,654 2,015 1,784 1,727 2,011 1,556 2,010 1,569
Dehydration 1,535 2,061 1,622 2,136 1,938 1,671 2,151 1,469 2,252 1,420
Composite: ACSC Chronic Conditions 13,818 16,160 14,629 15,240 16,221 14,162 18,667 12,033 16,789 13,457
Composite: ACSC Acute Conditions 5,505 6,960 5,857 6,841 6,998 5,719 7,154 5,362 6,631 5,757
Composite: ACSC Overall 19,322 23,118 20,484 22,082 23,217 19,881 25,819 17,394 23,417 19,213
Pressure Ulcer 4,208 5,894 4,514 6,063 5,607 4,599 5,878 4,212 5,616 4,432
Injurious Falls 111 175 135 143 167 124 162 119 156 125
HCBS Population Aged 65+ Short-Term Complications of Diabetes 124 151 126 163 147 130 174 108 170 107
Asthma or Chronic Obstructive Pulmonary Disease 3,959 6,245 4,677 5,400 6,064 4,460 6,495 3,758 5,880 4,036
Congestive Heart Failure 6,691 9,985 7,590 9,223 9,247 7,563 9,739 6,800 9,350 6,887
Composite: Potentially Preventable Infection 9,114 14,389 10,733 12,569 13,138 10,532 12,931 9,988 13,210 9,554
    Bacterial Pneumonia 5,601 8,725 6,524 7,766 8,478 6,285 7,992 6,033 7,951 5,920
    Urinary Tract Infection 3,514 5,664 4,209 4,803 4,659 4,247 4,939 3,955 5,258 3,634
Infection Due to Device or Implant 458 603 488 601 550 503 571 476 596 450
Dehydration 2,183 3,480 2,549 3,141 3,138 2,542 3,204 2,344 3,342 2,173
Composite: ACSC Chronic Conditions 13,508 19,662 15,241 18,061 18,507 15,067 20,036 13,165 18,848 13,584
Composite: ACSC Acute Conditions 8,609 13,732 10,164 12,022 12,875 9,874 12,461 9,362 12,450 9,143
Composite: ACSC Overall 22,116 33,392 25,404 30,079 31,379 24,939 32,495 22,525 31,295 22,726
Pressure Ulcer 3,775 4,848 4,198 4,163 4,122 4,211 4,880 3,737 5,013 3,549
Injurious Falls 436 657 486 644 754 449 493 541 533 513

Notes:

ACSC = ambulatory care-sensitive condition; HCBS = home and community-based services; I/DD = intellectual and development disabilities; SMI = serious mental illness.

a. All outcome indicators expressed as potentially avoidable hospital stays per 100,000 persons in the HCBS population. HCBS population for outcome indicators excludes: individuals under age 18; people with only institutional use in a given quarter; people on managed care plans; and persons in the States of Arizona, Maine, Washington, and Wisconsin.

Dually eligible = dually eligible for Medicaid and Medicare. Eligibility for Medicare defined as inclusion in Medicare denominator file.

Medicaid only = part of Medicaid HCBS population but not enrolled in Medicare.

HCBS subpopulations of I/DD, SMI, Under 65 Without I/DD or SMI, and 65+ are defined as in the Appendix.

Median is defined as the value at which half of States are below and half of States are above.

Source for Outcome Indicators: Agency for Healthcare Research and Quality (AHRQ), Medicaid Analytic eXtract (MAX) data, and Medicare Provider Analysis and Review (MedPAR) data.

Sources for column heading data are described in the Appendix.

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