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US News: Preventable Hospitalizations Shedding Light on Health Equity

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With this year’s release of Best Hospitals rankings, U.S. News & World Report developed measures aimed at capturing how effectively hospitals contribute to racial health equity in their communities, including an assessment that focuses on hospitalizations for conditions such as asthma, diabetes or high blood pressure. With adequate outpatient management, these types of “ambulatory care sensitive conditions” often do not require hospitalization, so examining such potentially preventable occurrences across racial groups can offer a window into possible disparities in preventive care.  Potentially preventable hospitalizations help shed light on the physical and social conditions influencing health in a community.

The Best Hospitals assessment compares the rates of potentially preventable hospitalizations among Black and non-Black Medicare beneficiaries in a given hospital service area, or HSA – a group of ZIP codes representing the community served by a hospital. Using data from 2015 – the most recent year this type of data was available by race – HSA discharge rates for Black beneficiaries with these conditions are also compared with the average discharge rate for all beneficiaries nationwide. HSAs are then placed into one of four categories based on their performance. They’re placed in one of three categories based on their performance over time.

Close to 400 HSAs were assessed on a community level, with a similar total assessed in comparison to the national average. Overall, 229 HSAs representing 645 hospitals landed in the best category available for at least one of the three preventive care metrics. Yet in more than 70% of the HSAs analyzed, Black beneficiaries were moderately to substantially more likely than non-Black beneficiaries to be hospitalized with these conditions.  The U.S. News assessment of preventive care offers a starting point for understanding health equity in hospital communities.

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