Overutilization
By jeremy.engdahl-johnson
We’ve blogged before about the relationship between healthcare costs and utilization. The topic is of interest in Pittsburgh, where facilities see utilization that exceeds national benchmarks. The Pittsburgh Post-Gazette has the story:
Younger people are also going to the hospital more often here than in other regions. A 2010 study by the actuarial firm Milliman found that for commercially insured individuals, the Pittsburgh region had 6 percent more hospital admissions and 26 percent more emergency room visits than the national average. We had one of the highest rates of emergency room use among 33 regions it analyzed.
High rates of hospitalizations, surgeries and emergency room use are not only expensive, but they’re also signs that the region’s health care systems aren’t functioning efficiently or effectively.
Many of the chronic disease patients being hospitalized today could stay healthier and avoid the need for hospitalization through better primary care and patient support services.
A great place to start is by reducing readmissions — Pennsylvania Health Care Cost Containment Council data show that 23 percent of the chronic disease patients in Pittsburgh who are hospitalized end up back in the hospital in less than a month. These high readmission rates can be significantly reduced; for example, projects organized by the Pittsburgh Regional Health Initiative at UPMC St. Margaret and at Premier Medical Associates showed that improving care for chronic disease patients can reduce readmission rates by 40 percent or more.
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