title: The association between long-term care setting and potentially preventable hospitalizations among older dual eligibles.
abstract: OBJECTIVE
  To compare the probability of experiencing a potentially preventable hospitalization (PPH) between older dual eligible Medicaid home and community-based service (HCBS) users and nursing home residents.
  
  
  METHODS
  Three years of Medicaid and Medicare claims data (2003-2005) from seven states, linked to area characteristics from the Area Resource File.
  
  
  METHODS
  A primary diagnosis of an ambulatory care sensitive condition on the inpatient hospital claim was used to identify PPHs. We used inverse probability of treatment weighting to mitigate the potential selection of HCBS versus nursing home use.
  
  
  RESULTS
  The most frequent conditions accounting for PPHs were the same among the HCBS users and nursing home residents and included congestive heart failure, pneumonia, chronic obstructive pulmonary disease, urinary tract infection, and dehydration. Compared to nursing home residents, elderly HCBS users had an increased probability of experiencing both a PPH and a non-PPH.
  
  
  CONCLUSIONS
  HCBS users' increased probability for potentially and non-PPHs suggests a need for more proactive integration of medical and long-term care.
authors.affiliation: Center for Gerontology and Healthcare Research, Brown University, Box G-S121-6, Providence, RI, 02912.
authors.forename: Andrea
authors.initials: A
authors.lastname: Wysocki
authors.forename: Robert L
authors.initials: RL
authors.lastname: Kane
authors.forename: Ezra
authors.initials: E
authors.lastname: Golberstein
authors.forename: Bryan
authors.initials: B
authors.lastname: Dowd
authors.forename: Terry
authors.initials: T
authors.lastname: Lum
authors.forename: Tetyana
authors.initials: T
authors.lastname: Shippee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services / Q000706:statistics & numerical data*; D063026:Dual Medicare Medicaid Eligibility; D005260:Female; D006699:Home Care Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008484:Medicaid; D009735:Nursing Homes; D014481:United States
keywords: Long-term care; Medicaid; Medicare; acute inpatient care; home care/nursing homes