Potentially Preventable Hospitalizations Among Adults With Traumatic Spinal Cord Injury: Assessment of Prevention Quality Indicators.

Abstract

Objectives: To assess rates of potentially preventable hospitalizations (PPHs) among adults with spinal cord injury (SCI) living in South Carolina using prevention quality indicators (PQIs).

Methods: We assessed hospitalizations in nonfederal state hospitals between 2016 and 2018 for 2531 adults (>18 years old) with chronic (>1 year) traumatic SCI who were identified through a statewide population-based registry. PPHs were identified using the computer code, definitions, and framework for PQIs developed by the Agency for Healthcare Quality and Research (AHRQ). The rates of PPH, as measured by the 14 PQIs, were calculated for those living with SCI in South Carolina and were compared to state and national rates.

Results: The rates of PPH for those with SCI were significantly higher than the state rates for 3 conditions (chronic obstructive pulmonary disease/asthma, pneumonia, urinary tract infection) and 3 composite indicators. The state population rates were significantly higher than the national rates for all but one indicator. Among those with SCI, the PQI overall composite rate was 3303 per 100,000, compared to a state rate of 1503 and a national rate of 1301.

Conclusions: Compared to the general population, adults with chronic SCI experience more hospitalizations that could have been prevented with high-quality and routine ambulatory care. There is a need to better monitor and treat these ambulatory care sensitive conditions, to advance our understanding of the access to and receipt of quality healthcare, and to develop and implement targeted services to promote health and prevent hospitalizations.