scholarly journals Osteoarthritis and risk of hospitalization for ambulatory care sensitive conditions: A general population-based cohort study

Rheumatology ◽  
2021 ◽  
Author(s):  
Ali Kiadaliri ◽  
Martin Englund
Keyword(s):  
Ambulatory Care ◽  
Hazard Model ◽  
Population Based ◽  
Incidence Rates ◽  
Ambulatory Care Sensitive Conditions ◽  
Chronic Obstructive ◽  
Main Diagnosis ◽  
Increased Risk ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Abstract Objective To determine the association between osteoarthritis (OA) and risk of hospitalization for ambulatory care sensitive conditions (HACSCs). Methods We included all individuals aged 40–85 years who resided in Skåne, Sweden on 31st December 2005 with at least one healthcare consultation during 1998–2005 (n = 515 256). We identified those with a main diagnosis of OA between January 1, 1998 and December 31, 2016. People were followed from January 1st 2006 until an HACSC, death, relocation outside Skåne, or December 31st 2016 (whichever occurred first). OA status was treated as a time-varying covariate (those diagnosed before January 1, 2006 considered as exposed for whole study period). We assessed relative (hazard ratios (HRs) using Cox proportional hazard model) and absolute (hazard difference using additive hazard model) effects of OA on HACSCs adjusted for potential confounders. Results Crude incidence rates of HACSCs were 239 (95% CI 235, 242) and 151 (150, 152) per 10 000 person-years among OA and non-OA persons, respectively. The OA persons had an increased risk of HACSCs (HR [95% CI] 1.11 [1.09, 1.13]) and its subcategories of medical conditions except chronic obstructive pulmonary disease (HR [95% CI] 0.86 [0.81, 0.90]). There were 20 (95% CI 16, 24) more HACSCs per 10 000 person-years in OA compared with non-OA persons. While HRs for knee and hip OA were generally comparable, only knee OA was associated with increased risk of hospitalization for diabetes. Conclusion OA is associated with an increased risk of HACSCs, highlighting the urgent need to improve outpatient care for OA patients.

scholarly journals Depression and risk of hospitalisations and rehospitalisations for ambulatory care-sensitive conditions in Denmark: a population-based cohort study

BMJ Open ◽  
2015 ◽  
Vol 5 (12) ◽  
pp. e009878 ◽  
Author(s):  
Dimitry S Davydow ◽  
Morten Fenger-Grøn ◽  
Anette Riisgaard Ribe ◽  
Henrik Søndergaard Pedersen ◽  
Anders Prior ◽  
...  
Keyword(s):  
Cohort Study ◽  
Ambulatory Care ◽  
Population Based ◽  
Ambulatory Care Sensitive Conditions ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

scholarly journals Defining Ambulatory Care Sensitive Conditions for adults in Portugal

2020 ◽  
Author(s):  
João Sarmento ◽  
João Victor Muniz Rocha ◽  
Rui Santana
Keyword(s):  
Colorectal Cancer ◽  
Ambulatory Care ◽  
Adult Population ◽  
Healthcare Management ◽  
Ambulatory Care Sensitive Conditions ◽  
Chronic Obstructive ◽  
Venous Disease ◽  
Delphi Panel ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Abstract Background Ambulatory Care Sensitive Conditions (ACSCs) are health conditions for which adequate management, treatment and interventions delivered in the ambulatory care setting could potentially prevent hospitalization. Which conditions are sensitive to ambulatory care varies according to the scope of health care services and the context in which the indicator is used. The need for a country-specific validated list for Portugal has already been identified, but currently no national list exists. The objective of this study was to develop a list of Ambulatory Care Sensitive Conditions for Portugal.Methods A modified web-based Delphi panel approach was designed, in order to determine which conditions can be considered ACSCs in the Portuguese adult population. The selected experts were general practitioners and internal medicine physicians identified by the most relevant Portuguese scientific societies. Experts were presented with previously identified ACSC and asked to select which could be accepted in the Portuguese context. They were also asked to identify other conditions they considered relevant. We estimated the number and cost of ACSC hospitalizations in 2017 in Portugal according to the identified conditions.Results After three rounds the experts agreed on 34 of the 45 initially proposed items. Fourteen new conditions were proposed and four achieved consensus, namely uterine cervical cancer, colorectal cancer, thromboembolic venous disease and voluntary termination of pregnancy. In 2017 133,427 hospitalizations were for ACSC (15.7% of all hospitalizations). This represents a rate of 1,685 per 100,000 adults. The most frequent diagnosis were pneumonia, heart failure, chronic obstructive pulmonary disease/chronic bronchitis, urinary tract infection, colorectal cancer, hypertensive disease atrial fibrillation and complications of diabetes mellitus.Conclusions New ACSC were identified. It is expected that this list could be used henceforward by epidemiologic studies, health services research and for healthcare management purposes. ACSC lists should be updated frequently. Further research is necessary to increase the specificity of ACSC hospitalizations as an indicator of healthcare performance.

scholarly journals Identifying priorities for primary care investment in Ireland through a population-based analysis of avoidable hospital admissions for ambulatory care sensitive conditions (ACSC)

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e028744 ◽  
Author(s):  
Geraldine McDarby ◽  
Breda Smyth
Keyword(s):  
Primary Care ◽  
Ambulatory Care ◽  
Integrated Care ◽  
Hospital Admissions ◽  
Acute Hospital ◽  
Ambulatory Care Sensitive Conditions ◽  
Hospital System ◽  
Bed Days ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

BackgroundIn 2016, the Irish acute hospital system operated well above internationally recommended occupancy targets. Investment in primary care can prevent hospital admissions of ambulatory care sensitive conditions (ACSCs).ObjectiveTo measure the impact of ACSCs on acute hospital capacity in the Irish public system and identify specific care areas for enhanced primary care provision.DesignNational Hospital In-patient Enquiry System data were used to calculate 2011–2016 standardised bed day rates for selected ACSC conditions. A prioritisation exercise was undertaken to identify the most significant contributors to bed days within our hospital system. Poisson regression was used to determine change over time using incidence rate ratios (IRR).ResultsIn 2016 ACSCs accounted for almost 20% of acute public hospital beds (n=871 328 bed days) with adults over 65 representing 69.1% (n=602 392) of these. Vaccine preventable conditions represented 39.1% of ACSCs. Influenza and pneumonia were responsible for 99.8% of these, increasing by 8.2% (IRR: 1.02; 95% CI 1.02 to 1.03) from 2011 to 2016. Pyelonephritis represented 47.6% of acute ACSC bed days, increasing by 46.5% (IRR: 1.07; 95% CI 1.06 to 1.08) over the 5 years examined.ConclusionsPrioritisation for targeted investment in integrated care programmes is enabled through analysis of ACSC’s in terms of acute hospital bed days. This analysis demonstrates that primary care investment in integrated care programmes for respiratory ACSC’s from prevention to rehabilitation at scale could assist with bed capacity in acute hospitals in Ireland. In adults 65 years and over, including chronic obstructive pulmonary disease patients, the current analysis supports targeting community based pulmonary rehabilitation including pneumococcal and influenza vaccination programmes in order to reduce the burden of infection and hospitalisations. Further exploration of pyelonephritis is necessary in order to ascertain patient profile and appropriateness of admissions.

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