TodayReport: Hospitalization rates for some Pa. HMO patients rise
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PA State News
Article RatingHARRISBURG, Pa. (AP) — More adults covered by Pennsylvania’s HMOs were hospitalized for diabetes and other illnesses in 2006, while more children spent time in the hospital for asthma treatment, according to a state survey being released Friday.
The Pennsylvania Health Care Cost Containment Council, an independent state agency that analyzes hospital finances and quality of care, based its findings on an analysis of 2006 data for nine major for-profit health maintenance organizations. But it provided no national comparison of hospitalization rates and no explanation for why the numbers were increasing.
“This shows areas where HMOs can focus their quality improvement efforts,” council spokeswoman Stephanie Suran said.
For every 10,000 adult patients, 105.9 were hospitalized with diabetes, up from 94.3 the year before. The number of patients hospitalized for gastrointestinal infections rose from 3.9 to 4.8 during the same period, and the number of children hospitalized with asthma rose from 14.6 to 18.5.
Also, three of every 10,000 adults were hospitalized for high blood pressure, compared with 2.6 in 2005, and 5.5 were hospitalized with kidney and urinary tract infections, compared with 4.4 the year before.
Those statistics do not necessarily reflect a decline in the quality of preventive care, Suran said.
“Sometimes patients can experience problems if they don’t take their medications or follow other protocols,” Suran said.
Nearly 22 percent of Pennsylvanians under age 65, or 2.3 million, were enrolled in commercial managed care plans in 2006.
The report also noted that the state’s HMOs performed at or above national averages in most categories for providing preventive care in 2006, such as giving eye exams and cholesterol screenings to diabetes patients, immunizing children before they turn 2, and advising smokers to quit.
They lagged behind the national average in three areas, the report said: the percentages of patients screened for breast cancer and colon cancer and the percentage of patients whose long-term medication therapy was monitored annually.
The survey also found that 64 percent of patients gave their health plans a high rating in 2006, compared with 66 percent in 2005.
To receive preventive care, members of HMOs must choose a primary-care physician that participates in their plan. Those doctors must approve a member’s visit to a specialist.
