Preventable hospitalizations decline, but big differences among counties persist

December 28, 2010

By Daniel Weintraub

Preventable hospitalizations for ten health conditions have declined in California over the past decade, but wide disparities remain among the state’s 58 counties, according to new data from an agency that tracks statewide health trends.

The most dramatic progress has come in the reduction of hospitalizations for for chest pain, which declined by more than 60 percent, and for pediatric gastroenteritis and chronic obstructive pulmonary disease, which dropped by 40 percent over the past ten years.

Hospitalizations for three preventable conditions — urinary tract infections and hypertension and long-term complications from diabetes — have increased during the past ten years.

Overall, the hospitalization rate declined nearly 7 percent, from about 11,300 per 100,000 people in 1999 to about 10,530 in 2008, according to the data collected by the Office of Statewide Health Planning and Development.

Hospitalizations for preventable conditions are considered a sign of a community’s access — and use of — primary care services. Long-term complications from diabetes, for example, are believed to come from poor control of the disease over a long period of time, something that generally does not happen when a person has access to a regular doctor and goes to the doctor regularly for check-ups and care. Urinary tract infections can usually be treated with antibiotics prescribed by a doctor, heading off the need for hospitalization. And hypertension can be controlled with medication and lifestyle changes.

One interesting thing that shows up in the charts is how different counties lead the state in preventable hospitalizations for different conditions. The numbers for the counties have been adjusted for the age and sex of each county’s population to reflect the different risk factors among different groups, making it easier to compare how each county is doing.

Yuba County, for example, had more than 90 hospitalizations per 100,000 people for short-term complications of diabetes, nearly twice the statewide average. Santa Barbara County had fewer than 40 such cases per 100,000 residents.

Los Angeles County is the worst when it comes to high blood pressure. LA County had about 37 cases per 100,000 population, compared to the statewide average of about 28 cases. Sonoma and Fresno counties had only about 11 hospitalizations for hypertension per 100,000 residents.

Alameda County, meanwhile, was off the charts when it comes to pediatric asthma. Despite improvements over the past ten years, the county still averaged more than 250 hospitalizations per 100,000 children aged 2 to 17, which was 2.5 times the statewide average. Tulare and Merced counties had fewer than 50 such hospitalizations.

Dr. David Carlisle, director of the Office of Statewide Health Planning and Development, said the new numbers should help Californians better understand the health of their communities and spotlight places that need improvement.

“Through these prevention quality indicators communities can better focus on planning and shaping systems that better meet community needs,” Carlisle said in a statement released with the report.

To read the full report or see the county by county charts and maps, click here.

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