Table 3.
Rates of Potentially Preventable Hospitalizations by Beneficiary Residence and Hospital-Based Telehealth Post-Discharge and Enabling Services
| FULL MODEL | ANY PPH FOR ACUTE CONDITIONS |
ANY PPH FOR CHRONIC CONDITIONS |
||||||
|---|---|---|---|---|---|---|---|---|
| OR | 95% CI | p | OR | 95% CI | p | |||
| Metropolitan areas | Reference | Reference | ||||||
| Rural areas | 1.18 | 1.15 | 1.23 | <0.001 | 1.00 | 0.97 | 1.04 | 0.80 |
| Micropolitan areas | 1.07 | 1.05 | 1.09 | <0.001 | 1.01 | 0.99 | 1.02 | 0.37 |
| No telehealth post-discharge and no enabling services | Reference | Reference | ||||||
| Telehealth post-discharge but no enabling services | 0.87 | 0.83 | 0.91 | <0.001 | 0.97 | 0.93 | 1.01 | 0.11 |
| No telehealth post-discharge but with enabling services | 0.99 | 0.97 | 1.00 | 0.03 | 1.00 | 0.99 | 1.01 | 0.49 |
| Telehealth post-discharge and enabling services | 0.89 | 0.88 | 0.91 | <0.001 | 0.93 | 0.91 | 0.94 | <0.001 |
| Telehealth post-discharge but no enabling services × rural area | 0.79 | 0.68 | 0.91 | <0.001 | 0.84 | 0.74 | 0.95 | 0.01 |
| No telehealth post-discharge but with enabling services × rural area | 0.70 | 0.66 | 0.74 | <0.001 | 0.81 | 0.77 | 0.85 | <0.001 |
| Telehealth post-discharge and enabling services × rural area | 0.56 | 0.50 | 0.64 | <0.001 | 0.73 | 0.66 | 0.80 | <0.001 |
| Telehealth post-discharge but no enabling services × micropolitan areas | 0.87 | 0.80 | 0.95 | <0.001 | 0.85 | 0.78 | 0.91 | <0.001 |
| No telehealth post-discharge but with enabling services × micropolitan areas | 0.79 | 0.77 | 0.82 | <0.001 | 0.82 | 0.80 | 0.84 | <0.001 |
| Telehealth post-discharge and enabling services × micropolitan areas | 0.69 | 0.65 | 0.73 | <0.001 | 0.78 | 0.74 | 0.81 | <0.001 |
Data source: The main data sets used were the 100% inpatient Medicare FFS claims file for calendar year 2017 merged with the Medicare Master Beneficiary Summary File. We linked the CMS data with the ACS using beneficiaries' zip codes. CMS claims data were also linked to the 2017 AHA Annual Survey, which tracks detailed measures of services hospitals provided (including the enabling services) and HIT functions hospital adopted. Our sample included community-dwelling Medicare FFS beneficiaries, aged 65 years and older, with continuous enrollment in 2017 and who had at least one hospital visit in 2017. Elderly patients with Medicare Advantage or dual-eligible patients were not included. Our final sample size included 3,540,442 beneficiaries. Using the CBSAs in AHA data, residents were divided into three geographical categories: rural (n = 155,288), suburban (n = 574,063), and urban (n = 2,531,601). All the models (full model) controlled for the covariates presented in Table 1.