One-fourth of Pennsylvanians hospitalized in recent years with common chronic conditions had to be readmitted within a year, contributing significantly to the estimated $1 billion-plus in hospitalization costs for treating those conditions.

The findings are contained in an analysis by the Pennsylvania Health Care Cost Containment Council, based on data collected from 2004 to 2008 on four key chronic diseases: asthma, chronic obstructive pulmonary disease, diabetes and heart failure.

The readmissions accounted for nearly 30,000 additional hospitalizations during that period.

In many cases, hospitalization for the chronic conditions could have been prevented through lifestyle changes -- such as quitting smoking, improving eating habits, exercising and moderating alcohol consumption -- as well as earlier intervention and better disease management, said Joe Martin, executive director for HC4.

"There are going to have to be more efforts on trying to figure out how to get people to make lifestyle changes," he said. "That's a difficult thing to do because people don't want to be told how to lead their lives."

The report cites estimates that chronic diseases account for 80 percent of all health care costs and hospitalizations in Pennsylvania, 76 percent of all physician visits and 91 percent of all filled prescriptions.

One alarming statistic showed that the death rate from chronic obstructive pulmonary disease in Pennsylvania was 80 percent higher than the national average.

Karen Wolk Feinstein, president and CEO of the Jewish Healthcare Foundation and president and CEO of the Pittsburgh Regional Health Initiative, said air quality issues and a higher prevalence of smoking might be key factors.

She said the regional health initiative, with a $1 million grant from the Richard King Mellon Foundation, has been able to reduce readmission rates among 750 local patients being treated for chronic obstructive pulmonary disease by nearly 50 percent using such strategies as ensuring patients know how to use inhalers properly, offering more active smoke cessation programs and better monitoring.

"There is still a lot we can do, not only to lower the stress of the patients when their condition has run awry, but also to lower the huge cost of hospitalization," she said.

Other findings in the report showed hospital stays for diabetes increased 24.7 percent between 1997 and 2007; for asthma, 10.6 percent; and for heart failure, 5.3 percent.

However, the hospitalization rate for heart failure declined 16.2 percent from 2004 to 2008.

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