What are potentially preventable complications?

Potentially Preventable Complications (PPCs) are harmful events or negative outcomes that develop after hospital admission and may result from processes involved in care and treatment rather than from natural progression of the underlying illness.

What are potentially preventable events?

What are potentially preventable events (PPEs)? Potentially preventable events are unnecessary, costly–and often harmful—health services that could be avoided through more effective care and care coordination.

What is a preventable hospital stay?

Preventable hospital stays measures the number of hospital stays for ambulatory-care sensitive conditions per 100,000 Medicare enrollees. Rates measure the number of events (e.g., deaths, births) in a given time period (generally one or more years) divided by the average number of people at risk during that period.

What are avoidable admissions?

Avoidable admission is interpreted as having a very long chain of causation. The assumption is that people requiring unscheduled hospital admission could have taken steps to prevent the onset of diabetes, or associated complications, arising in the first place.

What percentage of hospital admissions are preventable?

More than 15 percent of all adult inpatient stays with a primary expected payer of Medicare were potentially preventable. Of all stays in 2017 with an expected payer of Medicare, 15.4 percent were potentially preventable.

What does inappropriate admission mean?

Inappropriate admissions may be identified where. a. Decisions were made in social, primary, secondary, prehospital and/or emergency services that other reasonable clinicians would regard as unsuitable to the patient’s needs and circumstance and; b. Unscheduled hospital admission directly followed.

What is likely to be the most common reason for unnecessary admissions?

Hospital organization-related problems are the main cause of inappropriate admissions.

What is an ambulatory care sensitive indicator?

Ambulatory Care Sensitive Conditions (ACSCs) are health conditions-diagnoses for which timely and effective outpatient care can help to reduce the risks of hospitalization by either preventing the onset of an illness or condition, controlling an acute episodic illness or condition, or managing a chronic disease [1].

What is a potentially preventable complication?

Potentially preventable complication: A harmful event or negative outcome, such as an infection or surgical complication, that occurs after a hospital admission or an LTC facility stay and might have resulted from care, lack of care or treatment during the admission or stay.

What is a potentially preventable hospital admission?

Potentially preventable hospital admission: A hospital admission or long-term care facility stay that might have been reasonably prevented with adequate access to ambulatory care or health care coordination.

How does Texas Health and Human Services use data to improve quality?

Texas Health and Human Services collects data on potentially preventable events and uses it to improve quality and efficiency. Managed care organizations and hospitals are financially accountable for potentially preventable complications and potentially preventable readmissions flagged by HHS.

What are potentially preventable events in PPE?

Potentially preventable events are encounters, which could be prevented, that lead to unnecessary services or contribute to poor quality of care. They are described below. The Distinguishing PPE Programs Chart will help distinguish the different program areas that run these metrics.