Acute Hospital Utilization (AHU)

For persons 18 years of age and older, the risk-adjusted ratio of observed-to-expected acute inpatient and observation stay discharges during the measurement period.

Why It Matters

In 2022, there were approximately 33.7 million total hospital admissions in the United States ⁽¹⁾.

Inpatient hospitalizations put patients at risk for adverse events. Regardless of a patient’s medical acuity, adverse events such as hospital-acquired infection, pressure ulcers and medication errors can accrue during a hospitalization ⁽²⁾. Studies show that nearly one-third of adults hospitalized in the intensive care unit develop a hospital-acquired infection ⁽⁸⁾. Older patients in particular are at increased risk for delirium, falls, and lower overall functioning while hospitalized ^{(9, 10)}. Medicaid patients are at higher risk for frequent hospital admissions due to chronic medical conditions and conditions related to substance abuse.

Hospital care accounts for 31% of health spending in the U.S ⁽³⁾. A study found that inpatient admission costs account for 21% of total Medicare benefit payments ⁽⁶⁾. A 2023 study of Massachusetts hospitals found nearly 7% of inpatient hospitalizations have a preventable adverse event and 1% of inpatient hospitalizations have a preventable adverse event that is serious, life-threatening or fatal ⁽⁷⁾.

While some hospitalizations occur for acute conditions and cannot be avoided, an increased focus has been placed on prevention of hospitalizations for potentially avoidable conditions ⁽⁴⁾. Some hospitalizations can be avoided with improved access to care, timely delivery of care and appropriate care coordination.

This measure will allow for comparison of acute inpatient and observation stay use across health plans and identify opportunities for quality improvement. Health plans can use person-centered care, ensure coordination between health care settings and develop multi-setting care plans to reduce avoidable hospitalizations ⁽⁵⁾.

Historical Results – National Averages

Performance results for this measure are currently unavailable. Visit our Quality Compass page to explore data licensing options and gain access to detailed performance results for this measure.