Poor communities have 22% higher hospitalizations

June 12, 2009

Despite national efforts to eliminate healthcare disparities, the poor have higher hospital admissions rates for conditions such as diabetes and asthma.

Despite national efforts to eliminate healthcare disparities, low-income Americans continue to have higher hospital admission rates for asthma and many other conditions, according to Agency for Healthcare Research and Quality (AHRQ) data.

According to AHRQ News and Numbers based on data in Hospital Stays Among People Living in the Poorest Communities, 2006, the rate of hospitalization among people living in the poorest areas was 22% higher compared with people residing in wealthier communities.

The rate of hospital stays among 45 to 64 year olds was nearly 50% higher for people in the lowest-income communities compared with other areas.

Rates of hospitalization for ambulatory-care-sensitive conditions were 32% to 87% higher among patients from the poorest communities. Patients from the poorest communities were more likely to be admitted for potentially preventable conditions-higher rates were seen for asthma (87% higher), diabetes with complications (77%), COPD (69%), CHF (51%), skin infections (49%), pneumonia (42%), dehydration (38%), urinary tract infection (37%), and nonspecific chest pain (32%).

Patients from the lowest income communities were more likely to receive most of the 20 top procedures performed in the hospital. The largest differences were seen for eye and ear procedures (81% higher), hemodialysis (80%), vaccination of newborns for hepatitis B (47%), ligation of Fallopian tubes (47%), and respiratory intubation (32%).

“If managed care executives have enrollees from poor communities in their plans, they should pay special attention to providing the outpatient services needed to prevent hospitalization for ambulatory care-sensitive conditions,” says Anne Elixhauser, PhD, senior research scientist, AHRQ.

Preventing the need for hospitalization should be the goal, according to Elixhauser. “Therefore access to good outpatient care should be paramount so that patients do not get so ill that they require hospitalization,” she says. “Other factors also may be playing a role, for example, some of these stays may be the result of rehospitalization [e.g., for CHF] which would indicate potential problems with outpatient follow-up and transitions of care-making sure that when they are discharged from the hospital, patients have appointments to see their doctors.”