Hospitalization rate of senior citizens higher here than other counties
BY TERRY FLORES tflores@kenoshanews.com
Kenosha County’s older residents are hospitalized more often than residents of surrounding counties, including Milwaukee, according to the latest data released earlier this month by state health officials.
Local aging and health care industry experts attribute the higher 2005 rates to a number of factors from excessive pollution, smoking and poor diets to better access to professional medical services.
According to the Wisconsin Bureau of Health Information and Policy, Kenosha County was highest among the state’s southeastern most counties in hospitalization rates for adults 65 and older with 380.5 per 1,000 population in 2005.
By comparison hospitalization rates for surrounding counties were 371.2 for Milwaukee, 368.2 for Racine, and 329 for Walworth. Average stays in days were 5.6 for Milwaukee, 5.4 for Kenosha, 5.3 for Racine and 4.9 for Walworth.
In Kenosha County, the hospitalization rates for residents age 65 and older were highest in injury-related cases, including hip fractures, or 31.2 per 1,000 population. They were followed by coronary heart disease, pneumonia, cerebrovascular disease or stroke, cancers and chronic obstructive pulmonary diseases, such as emphysema, at rates of 23, 22, 19, 17 and 13 per 1,000 population, respectively.
While injuries and heart disease were among the reasons people were hospitalized most in all four counties, stays for chronic lung diseases were highest in Kenosha County. According to the data, the hospitalization rate for the county was 12.6 per 1,000 population. The other three counties had rates of 9 to 10 per 1,000 population.
For agencies that work with older adults, a hospital stay can be directly or indirectly influenced by a number of factors including tobacco use and poor diets.
“We’re certainly not unique. But tobacco is a big one that has a long-term impact especially when you look at the elderly population,” said Gary Brown, executive director of Kenosha Aging and Family Services, Inc. “We know that smoking can have long-term effects even after they quit. Like most counties we’re also seeing a number of people who are obese. So smoking, obesity, poor diets and then with our power plant here — you throw that in with all the other things and that then begins to create those numbers.”
Indeed, Kenosha County led all others in southeastern Wisconsin with the highest rate of cigarette smoking, or 21 percent of adults older than 60 who were surveyed from 2000 to 2005. Nearly 31 percent of its residents did not exercise compared with the state’s 28 percent. Kenosha also had a higher percentage of obese people than either Milwaukee or Racine counties.
Brown said while he acknowledges the hospitalization rates for Kenosha County are only slightly higher than that of some southeastern Wisconsin counties, the state data also shows an upward trend for Kenosha. Starting in 2004, all other nearby counties showed downward trends in hospitalizations with the exception of Kenosha, he said.
“Maybe the difference is not that great but what you’re talking about is the trends. When you look at it over a long period of time, ours is getting higher,” he said.
Ric Schmidt, president and chief executive officer of United Hospital System in Kenosha, said hospitals in some counties, especially Milwaukee, began limiting patient access points.
“For example, they decided to start treating some patients only at Sinai Samaritan and then there were physician clinics that consolidated,” he said. “If physicians are not taking Medicare or Medicaid patients, or limiting that number, plus the shutting down of some hospitals, that’s probably why hospital admissions in Milwaukee dipped,” he said, adding they contribute to lower hospitalization rates.
On the other hand, Kenosha County appears to have better access to care.
“We’ve added St. Catherine and there’s also Aurora. The ability to get into a practice is fairly easy,” he said.
And because doctors are the only ones who can call for admitting patients in hospitals, better access can lead to more people receiving care there, Schmidt said. In addition, very few doctors limit Medicare patients locally, he said.
Dr. A. John Capelli, a physician with Aurora Medical Center, said the area’s older population tier has a number of issues to deal with when it comes to its health. The older generation was part of a culture that worked very hard inside factories and auto plants. While the jobs they performed were physical, they were done under hazardous conditions that weren’t studied or rectified until many years later.
In addition, Capelli said, outside factors, including the philosophies doctors employ in treating their patients whether in the hospital, during office visits or by constantly motivating them to take care of themselves better may or may not have an impact on hospital rates.
While hospitalizations are not absolutely avoidable, there are ways people can prevent ending up there.
Richard Miller, a research analyst with Wisconsin’s health and information policy bureau, said statewide many hospitalizations could have been prevented.
According to the bureau, preventable hospitalizations are those in which the likelihood of hospitalizations could be reduced. Generally speaking, it may be by the patients themselves, heeding their doctors’ advice when they take the necessary medications, receive vaccines in a timely fashion and avoid situations or consumption of foods and drugs that aggravate their conditions, among others.
In Kenosha County 1,443 hospitalizations of adults 65 and older were likely preventable, or more than half the total hospitalizations. The average charge for per hospital stay for an older adult in the county was $16,101 for a total of $23.2 million for hospital stays considered preventable, according to the state data.
“The idea is to isolate things to where if a population has good primary care, meaning at the doctor level, the better that care, the less likely that a person would be hospitalized,” he said.
