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Complete Health Indicator Report of Ambulatory Care Sensitive Condition: Bacterial Pneumonia Hospitalization Among Adults

Definition

Ambulatory care sensitive (ACS) conditions refer to those conditions for which hospitalizations could have been avoided, or conditions that could have been less serious, if they had been treated early and appropriately. Good outpatient management dramatically reduces the risk of hospitalization. Bacterial pneumonia is a relatively common acute condition, treatable for the most part with antibiotics. If left untreated in susceptible individuals, such as the elderly, pneumonia can lead to death. For bacterial pneumonia, an ACS condition refers to bacterial pneumonia resulting in hospitalization. The risk-adjusted rate is the rate of hospitalizations of Utah residents of any age for bacterial pneumonia per 100,000 Utah population, adjusted for age and gender. As of November 2004, the IBIS bacterial pneumonia indicator information is based on one indicator (PQI 11) developed by the Agency for Healthcare Research and Quality Prevention Quality Indicators. The Agency for Healthcare Research and Quality and Healthcare Cost and Utilization Project (HCUP) provide the values for the national rate.

Numerator

Number of hospitalizations among adult Utah residents (age 18 years and older) with bacterial pneumonia as the principal diagnosis and excluding maternal, newborn, and transfer cases and cases with secondary diagnoses of sickle-cell anemia and HB-S disease.

Denominator

Number of Utah residents aged 18 years and older.

Data Interpretation Issues

High admission rates may reflect a large number of inappropriate admissions or low-quality treatment with antibiotics. Admission for bacterial pneumonia is not a measure of hospital quality, but rather one measure of outpatient and other health care. The Agency for Healthcare Research and Quality Prevention Quality Indicator for bacterial pneumonia includes hospitalized Utah adults of any age (18 years and older), and excludes cases that may result in over counting of bacterial pneumonia cases. Specific cases that are excluded are maternal cases, newborns, transfers from other institutions, and cases with secondary diagnoses of sickle-cell anemia and HB-S disease. The Utah bacterial pneumonia rate is risk-adjusted by age and gender so that comparison with the national rate is more meaningful. 95% confidence intervals are the criterion for statistical significance, that is, they indicate whether differences are real or due to "noise" in the data.

Why Is This Important?

Ambulatory care sensitive (ACS) conditions are conditions for which effective outpatient care can prevent hospitalizations. Outpatient care, including annual immunizations for influenza and pneumonia during the influenza season for at-risk people, can lessen the severity of bacterial pneumonia symptoms and prevent hospitalizations and death.

Other Objectives

Utah's 42 Community Health Indicators

How Are We Doing?

Based on this measure for available national data, Utah has had a significantly lower rate of hospitalizations due to bacterial pneumonia than the U.S. each year from 2006 through 2011 (the most recent available national data). Prior to this time frame, no clear trend exists.

How Do We Compare With the U.S.?

Based on this measure for available national data, Utah has had a significantly lower rate of hospitalizations due to bacterial pneumonia than the U.S. each year from 2006 through 2011 (the most recent available national data). Prior to this time frame, no clear trend exists. In fact, Utah had a significantly higher rate of hospitalization due to bacterial pneumonia than the U.S. in 2003.

What Is Being Done?

For patients at higher risk, two annual vaccinations can help prevent pneumonia. Pneumococcal vaccine is recommended for all immunocompetent individuals aged 65 years and older and for selected others at high risk. A pneumococcal conjugate vaccine is recommended for children.

Evidence-based Practices

Annual influenza vaccines (flu shots) and pneumococcal vaccines, especially for individuals aged 65 years and older, have been shown to lower rates of bacterial pneumonia.

Available Services

Community Nursing Services 6949 High Tech Drive Midvale, UT Phone: Toll Free (800) 486-2186 Flu Hotline: (801) 233-6170

Health Program Information

Utah Immunization Program (http://www.immunize-utah.org/index.html)


Related Indicators

Relevant Population Characteristics

Income, age, and education are important population characteristics related to hospitalization for ACS conditions.

Related Relevant Population Characteristics Indicators:


Health Care System Factors

People who lack health insurance coverage are likely to lack access to quality outpatient care, and in turn, are likely to be admitted as inpatients when ACS conditions worsen.

Related Health Care System Factors Indicators:


Related Risk Factors Indicators:


Related Health Status Outcomes Indicators:




Graphical Data Views

Bacterial Pneumonia Hospitalizations Among Adults, Utah, 2000-2012 and U.S., 2000-2011

::chart - missing::
confidence limits

Based on this measure for available national data, Utah has had a significantly lower rate of hospitalizations due to bacterial pneumonia than the U.S. each year from 2006 through 2011 (the most recent available national data). Prior to this time frame, no clear trend exists.
Utah vs. U.S.YearRisk-adjusted Rate per 100,000Lower LimitUpper Limit
Record Count: 34
Utah2000383.6372.3394.9
Utah2001378.6367.4389.8
Utah2002411.2400.1422.2
Utah2003450.7439.8461.6
Utah2004367.3356.6378.1
Utah2005409.8399.2420.4
Utah2006334.6324.2345.0
Utah2007324.6314.4334.8
Utah2008293.3283.2303.4
Utah2009282.7272.7292.6
Utah2010271.1261.3280.9
Utah2011265.6255.9275.3
Utah2012215.4207.1223.8
U.S.2000445.5437.4453.6
U.S.2001427.5420.1434.9
U.S.2002453.5445.0461.9
U.S.2003441.6433.7449.6
U.S.2004413.2405.5420.9
U.S.2005446.2436.2456.2
U.S.2006394.4385.2403.5
U.S.2007382.3374.8389.7
U.S.2008359.7352.2367.2
U.S.2009344.7337.3352.1
U.S.2010314.1307.8320.4
U.S.2011323.7317.4329.9

Data Notes

For Bacterial Pneumonia (PQI 11), the numerator includes principal diagnosis codes for bacterial pneumonia (481, 482.2, 482.30, 482.31, 482.32, 482.39, 482.41, 482.42, 482.9, 483.0, 483.1, 483.8, 485, 486) and excludes some secondary diagnoses such as sickle-cell/HB-C disease (282.41, 282.42, 282.60, 282.61, 282.62, 282.63, 282.64, 282.68, 282.69) as well as other codes.

Data Sources

  • Healthcare Cost and Utilization Project (HCUP), AHRQ
  • U.S. Census, County Intercensal Estimates (2000-2010)
  • Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics, Utah Department of Health
  • National Healthcare Quality and Research


Bacterial Pneumonia Hospitalizations Among Adults by Patient County of Residence, Utah, 2012

::chart - missing::
confidence limits

Among the 29 counties, the rates for Cache, Davis, Summit, and Weber counties were significantly lower than Utah overall. The rates for Beaver, Carbon, Emery, Garfield, Iron, Juab, Sanpete, Sevier, and Tooele counties were significantly higher than Utah overall.
CountyRisk-adjusted Rate per 100,000Lower LimitUpper Limit
Record Count: 30
Beaver800.5644.2956.7
Box Elder253.1194.4311.7
Cache159.3115.1203.5
Carbon521.6439.9603.3
Daggett**
Davis176.8151.1202.6
Duchesne217.0118.0316.0
Emery536.3414.7657.8
Garfield427.9272.6583.2
Grand288.8167.1410.5
Iron398.9334.9462.9
Juab799.0667.3930.7
Kane256.0129.3382.6
Millard240.0133.9346.2
Morgan131.50.0267.7
Piute**
Rich**
Salt Lake198.3184.6212.0
San Juan239.4131.0347.8
Sanpete390.0310.7469.4
Sevier408.5325.6491.4
Summit106.432.4180.4
Tooele312.6251.3373.9
Uintah269.5192.2346.7
Utah208.0186.0230.0
Wasatch270.1178.0362.2
Washington202.0172.5231.4
Wayne259.038.4479.6
Weber165.3137.8192.8
State215.4207.1223.8

Data Notes

**Some counties may not appear due to small occurrence rates. [[br]] For Bacterial Pneumonia (PQI 11), the numerator includes principal diagnosis codes for bacterial pneumonia (481, 482.2, 482.30, 482.31, 482.32, 482.39, 482.41, 482.42, 482.9, 483.0, 483.1, 483.8, 485, 486) and excludes some secondary diagnoses such as sickle-cell/HB-C disease (282.41, 282.42, 282.60, 282.61, 282.62, 282.63, 282.64, 282.68, 282.69) as well as other codes.

Data Sources

  • U.S. Census, County Intercensal Estimates (2000-2010)
  • Utah Inpatient Hospital Discharge Data, Office of Health Care Statistics, Utah Department of Health
  • National Healthcare Quality and Research
  • Healthcare Cost and Utilization Project (HCUP), AHRQ

References and Community Resources

Utah Immunization Program - http://www.immunize-utah.org/apps/flu/index.php Community Nursing Services - http://cns-cares.org/immunization

More Resources and Links

Evidence-based community health improvement ideas and interventions may be found at the following sites:

Additional indicator data by state and county may be found on these Websites:

Medical literature can be queried at the PubMed website.

For an on-line medical dictionary, click on this Dictionary link.

Page Content Updated On 11/18/2014, Published on 12/08/2014
The information provided above is from the Department of Health's Center for Health Data IBIS-PH web site (http://ibis.health.state.gov). The information published on this website may be reproduced without permission. Please use the following citation: " Retrieved Thu, 14 December 2017 3:12:33 from Department of Health, Center for Health Data, Indicator-Based Information System for Public Health Web site: http://ibis.health.state.gov ".

Content updated: Tue, 20 Dec 2016 15:48:06 MST