Potentially avoidable hospitalizations: inequalities in rates between US socioeconomic groups.
OBJECTIVE
The National Hospital Discharge Survey (NHDS) was used to evaluate potentially avoidable hospital conditions as an indicator of equity and efficiency in the US health care system.


METHODS
With the use of 1990 data from the NHDS, the National Health Interview Survey, and the census, national rates of hospitalization were calculated for avoidable conditions by age, race, median income of zip code, and insurance status.


RESULTS
An estimated 3.1 million hospitalizations were for potentially avoidable conditions. This was 12% of all hospitalizations in 1990 (excluding psychiatric admissions, women with deliveries, and newborns). Rates of potentially avoidable hospitalizations were higher for persons living in middle- and low-income areas than for persons living in high-income areas, and were higher among Blacks than among Whites. These class and racial differences were also found among the privately insured. Differences among income and racial groups for persons aged 65 and over were not significant.


CONCLUSIONS
Inequalities in potentially avoidable hospitalizations suggest inequity and inefficiency in the health care delivery system. Avoidable hospital conditions are a useful national indicator to monitor access to care.
Pappas
G
G
National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA.
Hadden
W C
WC
Kozak
L J
LJ
Fisher
G F
GF
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005006:Ethnicity; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007182:Income; D007348:Insurance, Health; D008297:Male; D008484:Medicaid; D008875:Middle Aged; D016017:Odds Ratio; D010351:Patient Discharge / Q000706:statistics & numerical data; D012923:Social Class; D012959:Socioeconomic Factors; D014481:United States