Trends in Avoidable Hospitalizations in A Developed City in Eastern China: 2015 to 2018

Abstract Objective: This study aimed to measure the avoidable hospitalization rate and the treatment cost per hospitalization time in large cities of eastern China.Methods: In this study, the hospital discharge data of all inpatients in the city from 2015 to 2018 were collected. In accordance with the organization for Economic Cooperation and Development (OECD) definition of avoidable hospitalizations, five diseases were selected as the measurement objects, including hypertension, diabetes, asthma, chronic obstructive pulmonary disease (COPD), as well as congestive heart failure (CHF). The basic characteristics and disease severity of patients were regulated using the linear probability model and the log-linear model, and the trend of avoidable hospitalization rate and treatment cost was examined according to the description of hospitalization rate, average cost per stay and average length of stay per stay.Results: From 2015 to 2018, the absolute number of avoidable hospitalizations in the city increased while fluctuating, which reached 125,372 in 2018. Among the five avoidable hospitalizations, the number of hospitalizations for diabetes increased continuously in the 4-year period. Congestive heart failure showed the most significant increase over the four years. Avoidable hospitalizations in the city have remained at a high level, while avoidable hospitalizations of hypertension and asthma fell to levels lower than those in 2015 in 2017 and 2018 after rising in 2016. The cost per hospitalization and length of stay per hospitalization decreased.Conclusions: Avoidable hospitalizations in the city remain at a high level, and more effective policies should be formulated to guide patients with avoidable hospitalizations, so as to more effectively exploit outpatient services and continuously improve the quality of primary health care services.