title: Potentially preventable hospitalizations for acute and chronic conditions in Alaska, 2010-2012.
abstract: OBJECTIVE
  The U.S. Agency for Healthcare Research and Quality's Prevention Quality Indicators comprise acute and chronic conditions for which hospitalization can be potentially prevented by high-quality ambulatory care. The Healthy Alaska 2020 initiative (HA2020) targeted reducing potentially preventable hospitalizations (PPH) for acute and chronic conditions among its health indicators. We estimated the PPH rate for adults aged ≥ 18 years in Alaska during 2010-2012.
  
  
  METHODS
  We conducted a cross-sectional analysis of state-wide hospital discharge data obtained from the Healthcare Cost and Utilization Project and the Indian Health Service. We calculated average annual PPH rates/1000 persons for acute/chronic conditions. Age-adjusted rate ratios (aRRs) were used for evaluating PPH rate disparities between Alaska Native (AN) and non-AN adults.
  
  
  RESULTS
  Among 127,371 total hospitalizations, 4911 and 6721 were for acute and chronic PPH conditions, respectively. The overall crude PPH rate was 7.3 (3.1 for acute and 4.2 for chronic conditions). AN adults had a higher rate than non-AN adults for acute (aRR: 4.7;p< 0.001) and chronic (aRR: 2.6;p< 0.001) PPH conditions. Adults aged ≥ 85 years had the highest PPH rate for acute (43.5) and chronic (31.6) conditions. Acute conditions with the highest PPH rate were bacterial pneumonia (1.8) and urinary tract infections (0.8). Chronic conditions with the highest PPH rate were chronic obstructive pulmonary disease (COPD; 1.6) and congestive heart failure (CHF; 1.3).
  
  
  CONCLUSIONS
  Efforts to reduce PPHs caused by COPD, CHF, and bacterial pneumonia, especially among AN people and older adults, should yield the greatest benefit in achieving the HA2020 goal.
authors.affiliation: Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Anchorage, AK, United States.
authors.forename: Prabhu P
authors.initials: PP
authors.lastname: Gounder
authors.affiliation: Division of High-Consequence Pathogens and Pathology, NCEZID, CDC, Atlanta, GA, United States.
authors.forename: Sara M
authors.initials: SM
authors.lastname: Seeman
authors.affiliation: Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Anchorage, AK, United States.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Holman
authors.affiliation: Division of Public Health, Alaska Department of Health and Social Services, Juneau, AK, United States.
authors.forename: Alice
authors.initials: A
authors.lastname: Rarig
authors.affiliation: Division of Public Health, Alaska Department of Health and Social Services, Juneau, AK, United States.
authors.forename: Mary K
authors.initials: MK
authors.lastname: McEwen
authors.affiliation: Healthcare Cost and Utilization Project, Center for Delivery, Organization and Markets, Agency for Healthcare and Research and Quality, Rockville, MD, United States.
authors.forename: Claudia A
authors.initials: CA
authors.lastname: Steiner
authors.affiliation: Division of Epidemiology and Disease Prevention, Indian Health Service, Rockville, MD, United States.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Bartholomew
authors.affiliation: Arctic Investigations Program, Division of Preparedness and Emerging Infections, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Centers for Disease Control and Prevention (CDC), Anchorage, AK, United States.
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Hennessy
keywords: AHRQ, Agency for Healthcare Research and Quality; AI/AN, American Indian/Alaska Native; AN, Alaska Native; CHF, congestive heart failure; COPD, chronic obstructive pulmonary disease; HA2020, Healthy Alaskans 2020; HDDS, Hospital Discharge Data Set; Health services research; Healthcare disparities; IHS, Indian Health Service; NPIRS, National Patient Information Reporting System; Native American; PQIs, Prevention Quality Indicators; Quality of health care; RR, age-specific rate ratio; SE, standard error; SID, State Inpatient Database; UTI, urinary tract infection; aRR, age-adjusted rate ratio