Max Rady College of Medicine

Concept: Avoidable Hospitalizations

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Concept Description

Last Updated: 2017-03-02


    Avoidable Hospitalizations are a set of 12 conditions for which hospitalization can be avoided if ambulatory care is provided in a timely and effective manner. (Weissman et al. 1992.) The conditions which are included in the grouping were those agreed upon by a panel of physicians and represent important health problems, which would be affected by appropriate ambulatory care, and have been used in previous studies.

    NOTE: Only PRIMARY hospital diagnoses are used in identifying conditions.

ICD-9-CM Diagnoses Codes for Avoidable Hospitalizations

    The following list identifies the Avoidable Hospitalization conditions and ICD-9-CM diagnoses codes that were used in the Population Health: Health Status Indicators deliverables by Cohen MM and MacWilliam L. in 1994. The list of codes is available in Appendix A, Table A2 in the deliverable Volume II: Tables and Figures.

    Condition ICD-9-CM Codes
    Ruptured appendix 540.0, 540.1
    Asthma 493
    Cellulitis 681, 682
    Congestive heart failure 428, 402.01, 402.11, 402.91
    Diabetes 250.1, 250.2, 250.3, 251.0
    Gangrene 785.4
    Hypokalemia 276.8
    Immunizable conditions 032, 033, 037, 072, 045, 055
    Malignant hypertension 401.0, 402.0, 403.0, 404.0, 405.0, 437.2
    Pneumonia 481, 482, 483, 485, 486
    Pyelonephritis 590.0, 590.1, 590.8
    Perforated or bleeding ulcer 531.0, 531.2, 531.4, 531.6, 532.0, 532.2, 532.4, 532.6, 533.0, 533.1, 533.2, 533.4, 533.5, 633.6

SAS Formats and Code

    Formats are available from MCHP for preparing the datasets.
    • avoid.fmt (format)
    • avoid.lab (label)


    Available from MCHP, developed by Leonard MacWilliam.

Related concepts 

Related terms 


  • Black C, Burchill C. An assessment of the potential for repatriating care from urban to rural Manitoba. Med Care 1999;37(6 Suppl):JS167-JS186. [Abstract] (View)
  • Cohen MM, MacWilliam L. Measuring the health of the population. Med Care 1995;33(12 Suppl):DS21-DS42. [Abstract] (View)
  • Cohen MM, MacWilliam L. Population Health: Health Status Indicators. Volume II: Tables and Figures. Winnipeg, MB: Manitoba Centre for Health Policy and Evaluation, 1994. [Report] (View)
  • Cohen MM, MacWilliam L. Population Health: Health Status Indicators. Volume I: Key Findings. Winnipeg, MB: Manitoba Centre for Health Policy & Evaluation, 1994. [Report] (View)
  • Roos LL, Traverse D, Turner D. Delivering prevention: the role of public programs in delivering care to high-risk populations. Med Care 1999;37(6 Suppl):JS264-JS278. [Abstract] (View)
  • Roos NP, Burchill CA, Black CD. Utilization of hospital resources. Med Care 1995;33 (12 Suppl):55-72. [Abstract] (View)
  • Roos NP, Mustard CA. Variation in health and health care use by socioeconomic status in Winnipeg, Canada: does the system work well? Yes and no. Milbank Q 1997;75(1):89-111. [Abstract] (View)
  • Weissman JS, Gatsonis C, Epstein AM. Rates of avoidable hospitalization by insurance status in Massachusetts and Maryland. JAMA 1992;268(17):2388-2394. [Abstract] (View)


  • ambulatory care
  • ambulatory care sensitive
  • Health Measures
  • health status indicators

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Manitoba Centre for Health Policy
Community Health Sciences, Max Rady College of Medicine,
Rady Faculty of Health Sciences,
Room 408-727 McDermot Ave.
University of Manitoba
Winnipeg, MB R3E 3P5 Canada