scholarly journals Machine learning application to the reduction of ambulatory care sensitive admissions (ACSA)

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
T Ngo ◽  
V Georgescu ◽  
C Gervet ◽  
A Laurent ◽  
T Libourel ◽  
...  
Keyword(s):  
Machine Learning ◽  
Primary Care ◽  
Health Care ◽  
Ambulatory Care ◽  
Support Vector ◽  
Care Services ◽  
Health Authorities ◽  
Primary Care Workforce ◽  
The Impact ◽  
Ambulatory Care Sensitive

Abstract Background Reducing Ambulatory Care Sensitive Admissions (ACSA) not only enhances patients’ quality of life but could also save substantial costs. ACSA are avoidable admissions for chronic conditions that are associated with socio-economic status, health status, utilization and readiness of primary care service as well as environmental factors. Undoubtedly, health authorities are highly interested in enhancing the health care services in order to reduce the number of ACSA. The objective is to identify the geographic areas where the primary care workforce should be increased in order to maximize the decrease in ACSA. Methods Using ambulatory care and inpatient claims data as well as contextual variables, we apply support vector machine regression (SVR) to select the geographic areas (fr. Bassins de vie - BVs) and the number of to-be-added primary care nurses that maximize the ACSA reduction. We also take into account the constraints related to budget and the equality of health care access. Particularly, there are three possible constraints: (1) the total number of nurses can be added in the whole region; (2) the maximum number of the nurses can be added at each area; (3) the maximum density of nurses (numbers of the nurses per 10,000 habitants) can be reached at each area. The results are visualized using spatial maps. Preliminary results In 2014, 27,000 ACSA occurred in the Occitanie, France region. For a specific set of constraints values, the model identified 16 BVs (out of 201) where the addition of 30 nurses could lead to the maximum ACSA reduction in number which is 17. Conclusions In the French Occitanie region, our SVR model was able to target a small number of geographic areas to maximize the impact of increased primary care workforce on ACSA. Our approach is applied to a single region, and it can be applied to other regions or extended at the national level as well as to other countries. Key messages A decision support tool to help health authorities in locating primary health care resources for the maximum reduction of ambulatory care sensitive admissions. An application of machine learning in primary care services.

Primary-Care Visits and Hospitalizations for Ambulatory-Care–Sensitive Conditions in an Inner-City Health Care System

2003 ◽  
Vol 3 (6) ◽  
pp. 324-328 ◽  
Author(s):  
John F. Steiner ◽  
Patricia A. Braun ◽  
Paul Melinkovich ◽  
Judith E. Glazner ◽  
Vijayalaxmi Chandramouli ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Inner City ◽  
Ambulatory Care ◽  
Health Care System ◽  
Ambulatory Care Sensitive Conditions ◽  
Care System ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

scholarly journals Influenza H1N1 2009 in Canterbury: a case study in pandemic response co-ordination

2010 ◽  
Vol 2 (4) ◽  
pp. 323 ◽  
Author(s):  
Daniel Williams ◽  
Annabel Begg ◽  
Kim Burgess ◽  
Michele Hider ◽  
Lance Jennings ◽  
...  
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Care ◽  
Influenza A ◽  
Health Care Services ◽  
Call Centre ◽  
Care Services ◽  
Influenza A H1n1 ◽  
Civil Defence ◽  
The Impact

BACKGROUND AND CONTEXT: Reviews of overseas pandemic responses have suggested that stronger links between primary care and other parts of the health sector are required. The influenza A (H1N1) 2009 (‘H1N1 09’) pandemic was the first real test of New Zealand’s pandemic preparedness. ASSESSMENT OF PROBLEM: In the six months from May to October 2009, there were 595 confirmed cases of H1N1 09 in Canterbury, with 187 hospitalisations and three deaths. This paper describes the way a range of Canterbury agencies worked together in a co-ordinated health-led response aimed at minimising the impact of H1N1 09 in the community and maintaining effective health care services for both influenza and non-influenza patients. STRATEGIES FOR IMPROVEMENT: Key strategies included sector-wide response co-ordination, intelligence and communications, a combined public health/primary care response during the ‘containment’ phase, and universal red/green streaming supported by dedicated ’flu centres and an 0800 call centre during the ‘manage it’ phase. LESSONS: Despite the considerable impact of the H1N1 09 virus in Canterbury, health care services were not overwhelmed. The key lesson learned from the Canterbury H1N1 09 response has been the importance of preparing and working together across the sector. KEYWORDS: Influenza, human; pandemic; primary health care; public health; mass media; civil defence

scholarly journals Exploring the Experiences of Changes to Support Access to Primary Health Care Services and the Impact on the Quality and Safety of Care for Homeless People During the COVID-19 Pandemic: A Study Protocol for A Qualitative Mixed Methods Approach.

2020 ◽  
Author(s):  
Kelly Howells ◽  
Martin Burrows ◽  
Mat Amp ◽  
Rachel Brennan ◽  
Wan-Ley Yeung ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Lived Experience ◽  
Health Care Services ◽  
Homeless People ◽  
Health Care Need ◽  
Seek Health Care ◽  
Care Services ◽  
High Level ◽  
The Impact

Abstract Background: Despite high level of health care need amongst people experiencing homelessness, poor access is a major concern. This is sometimes due to organisational and bureaucratic barriers, but also because they often feel stigmatised and treated badly when they do seek health care. The COVID-19 pandemic and the required social distancing measures have caused unprecedented disruption and change for the organisation of primary care, particularly for people experiencing homelessness. Against this back drop, there are many questions to address regarding whether the recent changes required to deliver services to people experiencing homelessness in the context of COVID-19 will help to address or compound problems in accessing care and inequalities in health outcomes. Methods: An action led and participatory research methodology will be employed to address the study objectives. Interviews with people experiencing homelessness were will be conducted by a researcher with lived experience of homelessness. Researchers with lived experience are able to engage with vulnerable communities in an empathetic, non-judgemental way as their shared experience promotes a sense of trust and integrity, which in turn encourages participation in research and may help people speak more openly about their experience. Interviews with health professionals and stakeholders exploring their experiences of delivering and facilitating care for homeless people during the pandemic will also be explored.Discussion: It is important to explore whether recent changes to the delivery of primary care in in response to the COVID-19 pandemic compromise the safety of homeless people and exacerbate existing health inequalities. This could have implications for how primary healthcare is delivered to those experiencing homelessness not only for the duration of the pandemic but in the future.

scholarly journals SUBSTANTIATION OF COMPONENTS OF AVAILABILITY AND INTEGRATION OF PRIMARY HEALTH CARE ASSOCIATED WITH AMBULATORY CARE SENSITIVE CONDITIONS IN UKRAINE

2021 ◽  
Vol 74 (3) ◽  
pp. 584-588
Author(s):  
Valery N. Lekhan ◽  
Liudmyla O. Hrytsenko
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Ambulatory Care ◽  
Action Plan ◽  
Ambulatory Care Sensitive Conditions ◽  
Family Doctors ◽  
Primary Health ◽  
The Impact ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

The aim: Identifying the components of availability of Primary Health Care (PHC) and integration between PHC and secondary Health care (SHC) which need strengthening to reduce the rate of Ambulatory Care Sensitive Hospitalizations (ACSH) in Ukraine. Materials and methods: The study was conducted in two stages: the focus of interviewing experts on the list of components of the availability of PHC and its integration with SHC; survey of our questionnaire is based on the results of the first stage of the study. The responses of 93 respondents – 20 experts and 73 general practitioners/family doctors – were analyzed using descriptive and analytical statistics. Results: There were identified 14 components of PHC availability and 8 integration components of PHC with SHC, their quantitative value (in points) of impact on ACSH. The informativeness of components is confirmed by the agreement of opinions of experts on their list (concordance coefficient W = 0.75 -0.87; p <0.01) and the reliable correlations of scores of impact assessments of the identified components with overall values of the impact availability PHC and the integration between PHC and SHC on the ACSH. Conclusions: The results of the study can be used to develop an action plan for reform of PHC, the implementation of which will reduce rates hospitalizations of Ambulatory care sensitive conditions and increase the efficiency use of limited resources of health care system of Ukraine.

scholarly journals Exploring the experiences of changes to support access to primary health care services and the impact on the quality and safety of care for homeless people during the COVID-19 pandemic: a study protocol for a qualitative mixed methods approach

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Kelly Howells ◽  
Martin Burrows ◽  
Mat Amp ◽  
Rachel Brennan ◽  
Wan-Ley Yeung ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Lived Experience ◽  
Health Care Services ◽  
Homeless People ◽  
Health Care Need ◽  
Seek Health Care ◽  
Care Services ◽  
High Level ◽  
The Impact

Abstract Background Despite high level of health care need amongst people experiencing homelessness, poor access is a major concern. This is sometimes due to organisational and bureaucratic barriers, but also because they often feel stigmatised and treated badly when they do seek health care. The COVID-19 pandemic and the required social distancing measures have caused unprecedented disruption and change for the organisation of primary care, particularly for people experiencing homelessness. Against this backdrop there are many questions to address regarding whether the recent changes required to deliver services to people experiencing homelessness in the context of COVID-19 will help to address or compound problems in accessing care and inequalities in health outcomes. Methods An action led and participatory research methodology will be employed to address the study objectives. Interviews with people experiencing homelessness were will be conducted by a researcher with lived experience of homelessness. Researchers with lived experience are able to engage with vulnerable communities in an empathetic, non-judgemental way as their shared experience promotes a sense of trust and integrity, which in turn encourages participation in research and may help people speak more openly about their experience. The experiences of health professionals and stakeholders delivering and facilitating care for people experiencing homelessness during the pandemic will also be explored. Discussion It is important to explore whether recent changes to the delivery of primary care in response to the COVID-19 pandemic compromise the safety of people experiencing homelessness and exacerbate health inequalities. This could have implications for how primary healthcare is delivered to those experiencing homelessness not only for the duration of the pandemic but in the future.

Sign in / Sign up

Export Citation Format

Share Document