title: Variation over time in preventable hospitalization rates across counties.
abstract: BACKGROUND
  The Agency for Health Care Research and Quality developed 14 prevention quality indicators (PQIs), including four PQIs related to preventable hospitalizations for diabetes and one to asthma. Quality indicators vary across counties, but variation over time has not been described.
  
  
  METHODS
  The Kentucky Cabinet for Health and Family Services published PQI data for each county in Kentucky in each of the 3 years from 2006 to 2008. Variation and correlations among PQI measures were calculated.
  
  
  RESULTS
  PQI rates often varied 10-fold between counties. Repeated measures of four PQIs were highly correlated, suggesting local health care processes that are stable over time. Some PQIs, such as PQI01--emergent complications of blood glucose control--correlated poorly with other measures. Other PQIs are correlated over geography and time, including PQI03 (long-term complications of diabetes); PQI14 (poorly controlled diabetes); and PQI15 (asthma).
  
  
  CONCLUSIONS
  These county PQI measures were stable over time. Stability implies that PQI measures were not the result of random processes and did not rapidly shift. However, some health improvement needs varied between counties. Although tailoring health promotion interventions to each county's needs may be complex, stable needs afford time to undertake targeted quality improvement efforts.
authors.affiliation: Department of Internal Medicine and General Medical Sciences, Washington University School of Medicine, St. Louis, MO, USA. wsumner@dom.wustl.edu
authors.forename: Walton
authors.initials: W
authors.lastname: Sumner
authors.forename: Michael D
authors.initials: MD
authors.lastname: Hagen
mesh_terms: D001249:Asthma / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy; D005843:Geography; D006760:Hospitalization / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D007629:Kentucky / Q000453:epidemiology; D011320:Primary Health Care / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data* / Q000639:trends; D013997:Time Factors