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HCUP Statistical Brief: Characteristics and Costs of Potentially Preventable Inpatient Stays

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Healthcare Cost and Utilization Project (HCUP) Statistical Brief 259 – Characteristics and Costs of Potentially Preventable Inpatient Stays, 2017 – presents weighted national estimates of potentially preventable inpatient stays using the State Inpatient Databases (SID) from 36 States. Potentially preventable stays were defined using the Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators (PQIs) and Pediatric Quality Indicators (PDIs). The PQIs and area-level PDIs were developed to identify hospitalizations for ACSCs.

This Statistical Brief presents statistics on potentially preventable inpatient stays separately for adults and children. Obstetric stays and neonatal stays are excluded. The total number of adult and pediatric potentially preventable stays and associated aggregate costs are presented for chronic and acute conditions. For adults, age-sex-adjusted rates are presented by patient characteristics and hospital census region for all conditions, chronic conditions only, and acute conditions only. The number of inpatient stays, aggregate costs, and mean cost per stay are presented for each condition category as well as for individual conditions. Additionally, volume and cost statistics are presented by primary expected payer. For children, age-sex-adjusted rates, as well as volume and cost statistics for four individual pediatric conditions are provided.

Highlights:

  • In 2017, 3.5 million potentially preventable adult inpatient stays accounted for $33.7 billion in aggregate hospital costs. These stays represented 12.9 percent of all nonobstetric stays and 8.9 percent of costs for all nonobstetric stays.
  • Of the 1,358,900 nonobstetric pediatric stays in 2017, 108,300 (8.0 percent) were potentially preventable. These preventable stays cost $561.6 million, or 2.8 percent of the $20.0 billion in aggregate hospital costs for all pediatric stays.
  • The most common and most expensive reason for potentially preventable stays was heart failure for adults (1,112,600 stays and $11.2 billion in aggregate hospital costs) and asthma for children (53,900 stays and $278.1 million in aggregate costs).

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