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 Public  policies reflected on hospitalizations for ambulatory care sensitive conditions: an ecological study in Sergipe-Brazil, 2008-2017

2020 ◽  
Author(s):  
Cátia Maria Justo ◽  
Kleyton de Andrade Bastos ◽  
Fúlvio Borges Nedel
Keyword(s):  
Health System ◽  
Ambulatory Care ◽  
Ecological Study ◽  
Public Policies ◽  
Initial Period ◽  
Ambulatory Care Sensitive Conditions ◽  
Unified Health System ◽  
Primary Health ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Abstract Background: Hospitalization for Ambulatory Care Sensitive Conditions (HACSC) are an indicator of failure at this level of the health system. Since 2006, a series of actions have been taken in Brazil to promote Primary Health Care (PHC), a situation that has changed radically since 2014. To analyze the trend of the HACSC in Sergipe, in the period from 2008 to 2017. Methods: Ecological time-trend analysis. The data were extracted from the hospital admission authorizations on Hospital Information System in Brazilian Unified Health System. It was classified according to the Brazilian List of HACSC. The rates were standardized by the indirect method. Findings: There were 608,083 non-obstetric admissions and 125,497 HACSC (20.6%), with an overall rate of 5.8 admissions per thousand inhabitants (5.7 male and 5.8 female). The trend described a U-curve, decreasing from 2008 to 2011, with little oscillation from 2011 to 2014, rising from 2014 to 2017. The rate was considerably higher in men over the age of 70. Throughout the period, the most frequent causes were: gastroenteritis and complications (15.6%), kidney and urinary tract infection (9.4%), asthma (9.2%), heart failure (8.8%), cerebrovascular (8.1%), and diabetes mellitus (7.2%). Conclusion: The indicator improved in the initial period of the study, following the introduction of public policies that strengthened PHC, and worsened as they were withdrawn or neglected.

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 Comparative research aspects on hospitalizations for ambulatory care sensitive conditions: the case of Brazil and Portugal

2020 ◽  
Vol 25 (4) ◽  
pp. 1375-1388 ◽  
Author(s):  
João Victor Muniz Rocha ◽  
João Sarmento ◽  
Bruno Moita ◽  
Ana Patrícia Marques ◽  
Rui Santana
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Ambulatory Care ◽  
Comparative Research ◽  
Comparative Approach ◽  
Ambulatory Care Sensitive Conditions ◽  
Primary Health ◽  
Methodological Aspects ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Abstract Hospitalizations for ambulatory care sensitive conditions have been used to measure access, quality and performance of the primary health care delivery system, as timely and adequate care could potentially avoid the need of hospitalization. Comparative research provides the opportunity for cross-country learning process. Brazil and Portugal have reformed their primary health care services in the last years, with similar organizational characteristics. We used hospitalization data of Brazil and Portugal for the year 2015 to compare hospitalizations for ambulatory care sensitive conditions between the two countries, and discussed conceptual and methodological aspects to be taken into consideration in the comparative approach. Brazil and Portugal presented similarities in causes and standardized rates of hospitalizations for ambulatory care sensitive conditions. There was great sensitivity on rates according to the methodology employed to define conditions. Hospitalizations for ambulatory care sensitive conditions are important sources of pressure for both Brazil and Portugal, and there are conceptual and methodological aspects that are critical to render the country-comparison approach useful.

Ambulatory care sensitive chronic conditions: what can we learn from patients about the role of primary health care in preventing admissions?

2018 ◽  
Vol 24 (4) ◽  
pp. 304 ◽  
Author(s):  
Jo M. Longman ◽  
Elizabeth Rix ◽  
Jennifer J. Johnston ◽  
Megan E. Passey
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Ambulatory Care ◽  
Chronic Conditions ◽  
Hospital Admissions ◽  
Telephone Interviews ◽  
Primary Health ◽  
Comprehensive Primary Health Care ◽  
Modifiable Factors ◽  
Ambulatory Care Sensitive

Developing and targeting interventions to reduce hospital admissions for ambulatory care sensitive (ACS) chronic conditions for older people is a key focus for improvement of the health system. To do this, an understanding of any modifiable factors that may contribute to such admissions is needed. To date, the literature on ACS admissions has rarely included the patient perspective. This qualitative study involved one-to-one telephone interviews with 24 patients aged ≥45 years who had had an unplanned admission for an ACS chronic condition to one of two participating regional hospitals between February and August 2015. Data were transcribed and analysed thematically. Most participants did not perceive their admission to be preventable, yet they described a series of interlinking factors, which may have contributed to their admission and which may offer potential points of leverage. Key interlinked themes interpreted were: ‘support deficits’, ‘non-adherence to treatment’ (including medication), ‘mental health’ and ‘lack of awareness or understanding of condition’. Improving system-, clinician- and patient-level factors within a framework of appropriately resourced and supported comprehensive primary health care that is accessible, affordable, holistic, practical and evidence-based may contribute to improving patients’ quality of life and to delaying or preventing hospital admission.

scholarly journals Are ambulatory care sensitive conditions a valid indicator for quality of primary health care?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
I Keskimäki ◽  
M Satokangas ◽  
S Lumme ◽  
V-M Partanen ◽  
M Arffman ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Ambulatory Care ◽  
Hospital Care ◽  
Ambulatory Care Sensitive Conditions ◽  
Care Organisation ◽  
Primary Health ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Abstract Background Hospitalisations due to ambulatory care sensitive conditions (ACSCs) have been used for assessing access to and quality of primary health care (PHC) in many countries. To assess the validity of ACSCs for assessing PHC performance we carried out a series of studies on regional and sociodemographic variations and time trends in ACSC hospitalisations and related mortality. Methods Hospitalisations due to ACSCs in Finland in 1992-2013 came from the national Hospital Discharge Register. The data were linked to population at risk data and individual sociodemographic indicators from Statistics Finland, and subsequently to area indicators of population health and socioeconomics, and health care organisation. Depending on study questions, we analysed ACSCs divided into acute, chronic and vaccine-preventable causes using appropriate statistical methods, such as multilevel Poisson models and trajectory modelling. Results We found ACSC hospitalisations to be highly associated to subsequent mortality with 4-10-fold excess 1-year mortality compared to the general population. ACSC hospitalisations showed substantial regional variations which declined over the study period due to decreasing variations in hospitalisations related to chronic ACSCs. The variations were mainly attributed to the hospital district level. In detailed analyses, about a quarter of the variance in ACSC hospitalisations was explained by individual level socioeconomic and health factors. In addition, population health indicators and factors related to hospital care organisation explained up to one third of the variance. Conclusions At patient level a hospitalisation due to ACSC is a sentinel event and associated to a high risk of poor health outcomes. However, using ACSC for benchmarking PHC providers should be addressed with caution and differences in sociodemographic factors and (co)morbidity of populations at risk, and regional heath and hospital care arrangements should be taken into account. Key messages Variations in hospitalisations due to ambulatory care sensitive conditions may mainly be linked to other factors than access to and quality of primary health care. More research is needed to validate ambulatory care sensitive conditions for use in assessing primary health care.

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