scholarly journals The Effects of Chronic Disease on Ambulatory Care–Sensitive Hospitalizations for Children or Youth

2019 ◽  
Vol 12 ◽  
pp. 117863291987942
Author(s):  
Charles D Phillips ◽  
Chau Truong ◽  
Hye-Chung Kum ◽  
Obioma Nwaiwu ◽  
Robert Ohsfeldt
Keyword(s):  
Chronic Disease ◽  
Ambulatory Care ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Ambulatory Care Sensitive Conditions ◽  
Hospital Discharges ◽  
Considerable Research ◽  
Complex Chronic Disease ◽  
Ambulatory Care Sensitive Hospitalizations ◽  
Ambulatory Care Sensitive

Considerable research has focused on hospitalizations for ambulatory care–sensitive conditions (ACSHs), but little of that research has focused on the role played by chronic disease in ACSHs involving children or youth (C/Y). This research investigates, for C/Y, the effects of chronic disease on the likelihood of an ACSH. The database included 699 473 hospital discharges for individuals under 18 in Texas between 2011 and 2015. Effects of chronic disease, individual, and contextual factors on the likelihood of a discharge involving an ACSH were estimated using logistic regression. Contrary to the results for adults, the presence of chronic diseases or a complex chronic disease among children or youth was protective, reducing the likelihood of an ACSH for a nonchronic condition. Results indicate that heightened ambulatory care received by C/Y with chronic diseases is largely protective. Two of more chronic conditions or at least one complex chronic condition significantly reduced the likelihood of an ACSH.

scholarly journals HOSPITALIZATIONS FOR AMBULATORY CARE SENSITIVE NONCOMMUNICABLE DISEASES OF THE CIRCULATORY SYSTEM

2017 ◽  
Vol 26 (1) ◽  
Author(s):  
José Marcel Mello ◽  
Pollyanna Kássia de Oliveira Borges ◽  
Erildo Vicente Muller ◽  
Clóris Regina Blanski Grden ◽  
Fabiane Karine Pinheiro ◽  
...  
Keyword(s):  
Ambulatory Care ◽  
Chronic Conditions ◽  
Ecological Study ◽  
Descriptive Analysis ◽  
Circulatory System ◽  
Cerebrovascular Diseases ◽  
Noncommunicable Diseases ◽  
Ambulatory Care Sensitive Conditions ◽  
Primary Health ◽  
Ambulatory Care Sensitive

ABSTRACT Objective: describe hospitalizations for ambulatory care sensitive chronic conditions in the state of Paraná, Brazil from 2000 to 2011 Method: epidemiological ecological study was to. After descriptive analysis of the data, hospitalization indicators were developed to describe the results. Results: this study’s findings suggest that efforts to implement and expand Primary Health Care in Paraná in the last decade resulted in a decrease in the proportion of hospitalizations for ambulatory care sensitive conditions and the average number of hospitalizations for noncommunicable chronic diseases, though the ratio of hospitalizations to resident population has increased. Conclusion: attention should be specifically paid to certain causes of hospitalization, such as hypertension and diabetes mellitus, to further minimize hospitalizations for Cerebrovascular Diseases and Congestive Heart Failure, which remained high.

scholarly journals Frequent Avoidable Admissions Amongst Aboriginal and Non-Aboriginal People with Chronic Disease in New South Wales, Australia: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Amanda Anne Jayakody ◽  
Christopher Oldmeadow ◽  
Mariko Carey ◽  
Jamie Bryant ◽  
Tiffany Evans ◽  
...  
Keyword(s):  
Ambulatory Care ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Retrospective Cohort ◽  
Aboriginal People ◽  
New South ◽  
New South Wales ◽  
South Wales ◽  
Avoidable Admissions ◽  
Ambulatory Care Sensitive

Abstract Background: Aboriginal and Torres Strait Islander people have high rates of avoidable hospital admissions for chronic diseases, however little is known about the frequency of avoidable admissions for this population. This study aimed to examine trends in avoidable admissions among Aboriginal and non-Aboriginal people with ambulatory care sensitive chronic conditions in New South Wales (NSW), Australia. Methods: A retrospective cohort analysis using de-identified linked administrative data of Aboriginal and non-Aboriginal patients between 2005/06 to 2013/14. Eligible patients were admitted to a NSW public hospital and who had one or more of the following ambulatory care sensitive chronic conditions as a principal diagnosis: diabetic complications, asthma, angina, hypertension, congestive heart failure and/or chronic obstructive pulmonary disease. The primary outcomes were the number of avoidable admissions for an individual in each financial year, and whether an individual had three or more admissions compared with one to two avoidable admissions in each financial year. Poisson and logistic regression models and a test for differences in yearly trends were used to assess the frequency of avoidable admissions over time, adjusting for sociodemographic variables and restricted to those aged ≤75 years.Results: There were a total of 27,467 avoidable admissions corresponding to 19,025 patients over the nine-year period (71.2% Aboriginal; 28.8% non-Aboriginal). Aboriginal patients were 15% more likely than non-Aboriginal patients to have a higher number of avoidable admissions per financial year (IRR=1.15; CI: 1.11, 1.20). Aboriginal patients were almost twice as likely as non-Aboriginal patients to experience three or more avoidable admissions per financial year (OR=1.90; CI=1.60, 2.26). There were no significant differences between Aboriginal and non-Aboriginal people in yearly trends for either the number of avoidable admissions, or whether or not an individual experienced three or more avoidable admissions per financial year (p=0.8599; 0.8608 respectively). Conclusion: Aboriginal people were significantly more likely to experience frequent avoidable admissions over a nine-year period compared to non-Aboriginal people. These high rates reflect the need for further research into which interventions are able to successfully reduce avoidable admissions among Aboriginal people with chronic diseases, and the importance of culturally appropriate early prevention and community health care.

Variation in Hospital Discharges for Ambulatory Care-Sensitive Conditions Among Children

PEDIATRICS ◽  
2000 ◽  
Vol 106 (Supplement_3) ◽  
pp. 942-948
Author(s):  
Jennifer D. Parker ◽  
Kenneth C. Schoendorf
Keyword(s):  
Ambulatory Care ◽  
Hospital Discharge ◽  
Ambulatory Care Sensitive Conditions ◽  
Hospital Discharges ◽  
Hospitalization Rates ◽  
Discharge Rates ◽  
The Us ◽  
Us Census ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Objective. Ambulatory Care-Sensitive Conditions (ACSCs), conditions for which ambulatory care may reduce, though not eliminate, the need for hospital admission, have been used as an index of adequate primary care. However, few studies of ACSC have focused on children. We estimated national hospitalization rates for ACSC among children and examined the behavior of the index between subgroups of children. Methods. We used data from the 1990–1995 National Hospital Discharge Surveys (NHDS), the US census, and the National Health Interview Survey (NHIS) to calculate hospital discharge rates. Rates were estimated as the number of condition-specific hospital discharges from the NHDS divided by the population at risk, as estimated from the US census and NHIS. Results. Predictably, ACSC hospitalization rates were significantly higher among children who were younger, black, had Medicaid insurance, and lived in poorer areas compared with their counterparts. However, the relationship between ACSCs and income and the distributions of conditions within the index varied significantly between children. Conclusions. ACSCs may indicate disparities in access and utilization of health care, however, the differing behavior of the index between subgroups suggests that inferences from examining rates of ACSCs may not be comparable for all children.ambulatory care-sensitive conditions, hospitalization rates.

scholarly journals Comparison and Impact of Four Different Methodologies for Identification of Ambulatory Care Sensitive Conditions

2020 ◽  
Vol 17 (21) ◽  
pp. 8121
Author(s):  
Andreia Pinto ◽  
João Vasco Santos ◽  
Júlio Souza ◽  
João Viana ◽  
Cristina Costa Santos ◽  
...  
Keyword(s):  
Ambulatory Care ◽  
Public Hospital ◽  
Intraclass Correlation ◽  
Healthcare Research ◽  
Ambulatory Care Sensitive Conditions ◽  
Hospital Discharges ◽  
Mainland Portugal ◽  
The Impact ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Ambulatory care sensitive conditions (ACSCs) are conditions for which hospitalizations are thought to be avoidable if effective and accessible primary health care is available. However, to define which conditions are considered ACSCs, there is a considerable number of different lists. Our aim was to compare the impact of using different ACSC lists considering mainland Portugal hospitalizations. A retrospective study with inpatient data from Portuguese public hospital discharges between 2011 and 2015 was conducted. Four ACSC list sources were considered: Agency for Healthcare Research and Quality (AHRQ), Canadian Institute for Health Information (CIHI), the Victorian Ambulatory Care Sensitive Conditions study, and Sarmento et al. Age–sex-adjusted rates of ACSCs were calculated by district (hospitalizations per 100,000 inhabitants). Spearman’s rho, the intraclass correlation coefficient (ICC), the information-based measure of disagreement (IBMD), and Bland and Altman plots were computed. Results showed that by applying the four lists, different age–sex-adjusted rates are obtained. However, the lists that seemed to demonstrate greater agreement and consistency were the list proposed by Sarmento et al. compared to AHRQ and the AHRQ method compared to the Victorian list. It is important to state that we should compare comparable indicators and ACSC lists cannot be used interchangeably.

scholarly journals Frequent avoidable admissions amongst Aboriginal and non-Aboriginal people with chronic disease in New South Wales, Australia: a retrospective cohort study

2020 ◽  
Author(s):  
Amanda Anne Jayakody ◽  
Christopher Oldmeadow ◽  
Mariko Carey ◽  
Jamie Bryant ◽  
Tiffany Evans ◽  
...  
Keyword(s):  
Ambulatory Care ◽  
Chronic Diseases ◽  
Chronic Conditions ◽  
Retrospective Cohort ◽  
Aboriginal People ◽  
New South ◽  
New South Wales ◽  
South Wales ◽  
Avoidable Admissions ◽  
Ambulatory Care Sensitive

Abstract Background: Aboriginal and Torres Strait Islander people have high rates of avoidable hospital admissions for chronic diseases, however little is known about the frequency of avoidable admissions for this population. This study aimed to examine trends in avoidable admissions among Aboriginal and non-Aboriginal people with ambulatory care sensitive chronic conditions in New South Wales (NSW), Australia. Methods: A retrospective cohort analysis using de-identified linked administrative data of Aboriginal and non-Aboriginal patients between 2005/06 to 2013/14. Eligible patients were admitted to a NSW public hospital and who had one or more of the following ambulatory care sensitive chronic conditions as a principal diagnosis: diabetic complications, asthma, angina, hypertension, congestive heart failure and/or chronic obstructive pulmonary disease. The primary outcomes were the number of avoidable admissions for an individual in each financial year, and whether an individual had three or more admissions compared with one to two avoidable admissions in each financial year. Poisson and logistic regression models and a test for differences in yearly trends were used to assess the frequency of avoidable admissions over time, adjusting for sociodemographic variables and restricted to those aged ≤75 years.Results: There were a total of 27,467 avoidable admissions corresponding to 19,025 patients over the nine-year period (71.2% Aboriginal; 28.8% non-Aboriginal). Aboriginal patients were 15% more likely than non-Aboriginal patients to have a higher number of avoidable admissions per financial year (IRR=1.15; CI: 1.11, 1.20). Aboriginal patients were almost twice as likely as non-Aboriginal patients to experience three or more avoidable admissions per financial year (OR=1.90; CI=1.60, 2.26). There were no significant differences between Aboriginal and non-Aboriginal people in yearly trends for either the number of avoidable admissions, or whether or not an individual experienced three or more avoidable admissions per financial year (p=0.8599; 0.8608 respectively). Conclusion: Aboriginal people were significantly more likely to experience frequent avoidable admissions over a nine-year period compared to non-Aboriginal people. These high rates reflect the need for further research into which interventions are able to successfully reduce avoidable admissions among Aboriginal people with chronic diseases, and the importance of culturally appropriate early prevention and community health care.

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