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Assessing the Health and Welfare of the HCBS Population

Table 8: Outcome Indicators for the Home and Community-Based Services Population by Participant Attributes, 2005a

Table 8B: Dually Eligible HCBS Participants

Outcome Indicator White Only, Non-Hispanic Black Only, Non-Hispanic Hispanic Other Race or Multiple Races, Non-Hispanic Unknown Race Male Female Ages 18-64 Ages 65-84 Age 85+ MSA Non-MSA
Short-Term Complications of Diabetes 195 451 208 92 151 266 213 378 153 74 225 261
  Min s s s s s s 121 s s s s s
  Max 706 1,662 6,316 4,771 s 1,345 619 1,490 1,021 235 821 831
Asthma or Chronic Obstructive Pulmonary Disease 4,646 3,708 3,149 1,802 3,865 3,400 4,458 2,791 5,510 3,041 3,677 5,585
  Min 1,063 s s s s 633 1,369 325 2,362 1,288 905 s
  Max 9,973 8,539 8,955 30,000 s 8,334 11,696 6,435 14,482 7,905 8,571 11,072
Congestive Heart Failure 5,565 8,374 5,800 2,891 5,656 4,390 6,715 2,546 7,529 10,071 5,534 7,348
  Min 1,796 s s s s 1,420 1,666 312 3,747 3,374 1,398 2,664
  Max 10,692 14,644 25,397 14,035 s 9,970 12,890 10,816 13,739 18,767 11,524 12,232
Composite: Potentially Preventable Infection 10,053 8,542 7,726 5,095 8,349 8,545 9,410 5,631 9,983 16,128 8,468 11,256
  Min 5,974 s s s s 6,011 5,558 3,271 5,193 8,896 5,646 6,681
  Max 17,151 35,556 36,364 27,038 s 17,470 16,542 9,978 20,951 31,034 15,497 18,170
    Bacterial Pneumonia 6,373 4,362 4,539 3,426 5,113 5,811 5,419 3,435 6,126 9,714 5,025 7,278
      Min 3,964 s s s s 3,975 3,284 2,238 3,279 5,215 3,582 4,186
      Max 10,817 22,222 9,185 14,517 s 11,941 9,382 5,891 13,104 21,944 8,391 11,300
    Urinary Tract Infection 3,680 4,180 3,187 1,669 3,236 2,734 3,991 2,196 3,857 6,414 3,443 3,978
      Min s s s s s 1,242 2,017 751 1,914 2,824 1,850 1,446
      Max 7,713 13,333 36,364 13,519 s 6,665 8,493 4,848 9,597 15,214 7,876 7,645
Infection Due to Device or Implant 572 1,401 882 362 601 743 731 1,066 605 225 743 739
  Min s s s s s s 224 215 s s s s
  Max 1,139 3,558 12,857 2,985 s 1,426 1,460 1,816 2,231 589 1,568 1,488
Dehydration 2,106 3,022 1,691 1,080 2,061 1,737 2,376 1,238 2,403 3,936 2,008 2,683
  Min s s s s s 475 714 375 1,064 1,007 452 620
  Max 4,227 6,171 4,420 5,783 s 3,483 4,796 2,391 5,238 8,114 4,383 4,589
Composite: ACSC Chronic Conditions 12,505 17,164 12,947 6,321 12,111 10,425 14,251 7,962 16,349 15,590 12,062 16,209
  Min 3,408 s s s s 3,243 3,452 1,126 7,806 3,988 2,919 4,948
  Max 23,903 29,841 44,444 109,091 s 18,993 26,365 17,105 31,276 26,495 21,492 26,641
Composite: ACSC Acute Conditions 9,218 7,983 7,030 4,579 7,775 7,149 9,031 4,652 9,483 15,315 7,608 11,006
  Min s s s s s 4,430 5,247 2,335 4,848 7,669 5,016 6,250
  Max 16,012 26,667 43,750 24,652 s 15,066 15,687 8,565 19,300 26,941 13,115 17,587
Composite: ACSC Overall 21,723 25,144 19,975 10,900 19,884 17,572 23,281 12,613 25,831 30,902 19,668 27,213
  Min 8,723 s s s s 7,673 9,820 3,754 12,971 11,656 7,935 10,256
  Max 39,914 44,860 74,074 109,091 s 34,059 41,284 22,863 50,576 50,856 32,463 44,228
Pressure Ulcer 3,472 6,789 3,352 1,525 3,397 4,095 3,804 3,300 3,854 5,806 3,982 3,777
  Min 1,663 s s s s 1,775 1,548 1,208 1,220 1,064 1,625 918
  Max 7,916 20,000 16,970 11,285 s 11,025 10,192 7,947 11,816 13,629 9,756 9,500
Injurious Falls 455 223 286 233 382 193 477 129 454 836 328 556
  Min s s s s s s s s s s s s
  Max 2,128 841 562 6,579 s 1,066 2,181 340 2,539 5,521 2,275 2,762

Notes:

ACSC = ambulatory care-sensitive condition; I/DD = intellectual and development disabilities; MSA = metropolitan statistical area; 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 people in the States of Arizona, Maine, Washington, and Wisconsin.

Minimum (min) and maximum (max) defined as lowest rate and highest rate among States.

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.

s = Suppressed due to small cell size.

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

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