scholarly journals Regional Characteristics of Hospital Admissions and Outpatients Visits with Arterial Hypertension from the Point of the WHO Concept of Ambulatory Care Sensitive Conditions

2020 ◽  
Vol 16 (6) ◽  
pp. 948-957
Author(s):  
A. V. Kontsevaya ◽  
Yu. V. Doludin ◽  
M. B. Khudyakov ◽  
O. M. Drapkina
Keyword(s):  
Arterial Hypertension ◽  
Ambulatory Care ◽  
Hospital Admissions ◽  
Federal District ◽  
Ambulatory Care Sensitive Conditions ◽  
North Caucasus ◽  
The North ◽  
Federal Districts ◽  
Ambulatory Care Sensitive

Aim. To analyze hospital admission and ambulatory care of the patients with arterial hypertension (AH) in federal districts and regions from the perspective of the WHO concept of diseases, which can be treated in ambulatory settings (ambulatory care sensitive conditions, ACSC).Material and methods. For analysis we used data from annual forms of federal statistical monitoring (12 and 14), which includes data on hospital admissions with hypertension in federal districts and separate regions in 2017. Hypertension included diseases characterized by raised blood pressure, ICD10: I10-I13.Results. We performed the analysis of 12 and 14 forms per districts and regions of the Russian Federation. Regions with increased hospitalization rates and an increased ratio of the hospitalizations to number to outpatients visits were identified. High variability of these indicators was observed both among both between regions and federal districts. The values of the ratio indicator vary from 0.0131 in the Nizhny Novgorod Region to 0.0234 in the Chechen Republic. The average value of the ratio in the federal district varies from 0.032 in the Volga Federal District to 0.119 in the North Caucasus Federal District. In the North Caucasus and Far East Federal District the value of the indicator is significantly higher than in other districts.Conclusion. Assessing diseases which can be treated in ambulatory setting scan be one of the tools for evaluating the quality of medical care in primary care facilities. However, before including ACSC as an indicator of the quality of health care delivery, a deeper understanding of the reasons that can impact its rates is required.

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.

scholarly journals Dynamics of the volume and structure of hospital admissions for emergency indications in surgical hospitals of the Stavropol territory with disorders of the digestive organs

2012 ◽  
Vol 93 (1) ◽  
pp. 134-138
Author(s):  
J V Mikhaylova ◽  
I M Son ◽  
K A Muravev
Keyword(s):  
Acute Pancreatitis ◽  
Hospital Admissions ◽  
Abdominal Cavity ◽  
Federal District ◽  
North Caucasus ◽  
Duodenal Ulcers ◽  
Digestive Organs ◽  
The North ◽  
The Russian Federation ◽  
Number Of Individuals

Aim. To determine the volume and structure of hospital admissions for emergency indications in the surgical hospitals of the Stavropol Territory, of the North Caucasus Federal District and of the Russian Federation with disorders of the digestive organs over a 10-year period. Methods. Conducted was a comparative analysis of the volume and structure of hospital admissions for emergency indications in surgical hospitals over a 10-year period. Results. The number of individuals admitted to Russian hospitals for emergency medical treatment for disorders of the digestive system from 2001 to 2010 has increased by 4.6%. There was a significant reduction in the number of cases of acute appendicitis and perforated gastric and duodenal ulcers, while the share of acute pancreatitis and acute intestinal obstruction increased. Conclusion. Acute pancreatitis, appendicitis and cholecystitis - are the most common emergency conditions in the Stavropol Territory in the pathology of the organs of the abdominal cavity.

scholarly journals Epidemiological Situation on Tick-Borne Borreliosis in the Russian Federation in 2019 Compared to the Period of 2002–2018

2020 ◽  
pp. 131-138
Author(s):  
S. A. Rudakova ◽  
N. A. Pen’evskaya ◽  
A. I. Blokh ◽  
D. A. Savel’ev ◽  
O. E. Teslova ◽  
...  
Keyword(s):  
Russian Federation ◽  
Federal District ◽  
Effective Control ◽  
North Caucasus ◽  
North West ◽  
Main Research ◽  
The North ◽  
Federal Districts ◽  
The Russian Federation ◽  
Epidemiological Situation

Objective: to analyze the epidemiological situation on Ixodidae tick-borne borreliosis in the Russian Federation in 2019 in comparison with the period of 2002–2018.Materials and methods. The paper uses the data contained in Form No. 2 of the state statistical reporting for 2002–2019 and information obtained by the Reference Center for Monitoring Borreliosis of the Omsk Research Institute of Natural Focal Infections from 74 constituent entities of Russia in 2019. The main research method is epidemiological one with the use of modern information technologies.Results and discussion. In Russia, 8048 cases of tick-borne borreliosis (Lyme disease – LD) were recorded (5.48 0/0000) in 2019. The actual indicators of the LD incidence for the whole country and federal districts (FD) in 2019 were within the confidence limits predicted with linear regression based on the study of the dynamics of the epidemic process in 2002–2018 in the vast majority of cases. A steady upward trend in the LD incidence was observed during 2002–2019 in the Central Federal District due to 10 out of 18 entities (Moscow, Belgorod, Lipetsk, Moscow, Bryansk, Voronezh, Kursk, Ryazan, Tambov, Tula regions); in the Southern Federal District because of the Krasnodar Territory and the Volgograd Region; in the North Caucasus Federal District – because of the Stavropol Territory. Despite the fact that a downward trend in the incidence of LD has been established over the past 18 years in the North-West, Volga and Ural Federal Districts, in some subjects of these regions a trend towards an aggravation of the epidemiological situation is observed (the Komi Republic and Chuvashia, Penza Region). In the absence of a pronounced tendency to change in the incidence rate of LD in the Siberian and Far Eastern Federal Districts, Kemerovo Region-Kuzbass, the Republic of Tuva and the Trans-Baikal Territory where a growing trend has been identified require special attention. In the Ural and Siberian Federal Districts, the share of non-erythema forms among laboratory-confirmed cases of LD was higher than in other regions, which merits further study of the genome-specific features of borrelia populations and their carriers. Effective control of the LD epidemiological situation in Russia is possible provided that the control is improved and maintained, and the capacity of preventive measures and zoological-entomological monitoring of the activity and structure of the natural foci of LD is enhanced in the entities with the long-term tendency towards increase in the incidence of the disease. 

scholarly journals The Victorian Ambulatory Care Sensitive Conditions Study: reducing demand on hospital services in Victoria

2002 ◽  
Vol 25 (2) ◽  
pp. 71 ◽  
Author(s):  
Zahid Ansari ◽  
Norman Carson ◽  
Adrian Serraglio ◽  
Toni Barbetti ◽  
Flavia Cicuttini
Keyword(s):  
Ambulatory Care ◽  
Pneumococcal Pneumonia ◽  
Diabetes Complications ◽  
Hospital Admissions ◽  
Ambulatory Setting ◽  
Ambulatory Care Sensitive Conditions ◽  
Hospital Services ◽  
Admission Rates ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Ambulatory Care Sensitive Conditions (ACSCs) are those for which hospitalisation is thought to be avoidable ifpreventive care and early disease management are applied, usually in the ambulatory setting. The Victorian ACSCs study offers a new set of indicators describing differentials and inequalities in access to the primary healthcare systemin Victoria. The study used the Victorian Admitted Episodes Dataset (1999-2000) for analysing hospital admissions for diabetes complications, asthma, vaccine preventable influenza and pneumococcal pneumonia. The analyses were performed at the level of Primary Care Partnerships (PCPs). There were 12 100 admissions for diabetes complicationsin Victoria. There was a 12-fold variation in admission rates for diabetes complications across PCPs, with 13 PCPs having significantly higher rates than the Victorian average, accounting for just over half of all admissions (6114) and39 per cent total bed days. Similar variations in admission rates across PCPs were observed for asthma, influenza and pneumococcal pneumonia. This analysis, with its acknowledged limitations, has shown the potential for using theseindicators as a planning tool for identifying opportunities for targeted public health and health services interventions in reducing demand on hospital services in Victoria.

Ambulatory Care Sensitive Conditions Among All-Payer Claimants With Intellectual and Developmental Disabilities

2021 ◽  
Vol 126 (3) ◽  
pp. 203-215
Author(s):  
Kimberly G. Phillips ◽  
Jeanne S. Wishengrad ◽  
Andrew J. Houtenville
Keyword(s):  
Developmental Disabilities ◽  
Ambulatory Care ◽  
Hospital Admissions ◽  
International Classification Of Diseases ◽  
Care Utilization ◽  
Ambulatory Care Sensitive Conditions ◽  
Intellectual And Developmental Disabilities ◽  
Inpatient Hospitalizations ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Abstract Inpatient hospitalizations for ambulatory care sensitive conditions (ACSC) among beneficiaries with and without intellectual and developmental disabilities (IDD) were examined using Medicaid and commercial claims from 2010–2014 in New Hampshire. IDD was defined with International Classification of Diseases, Ninth Edition, Clinical Modification (ICD-9-CM) codes using algorithms from the Centers for Medicare and Medicaid Services, and inpatient encounters were identified using the Healthcare Effectiveness Data and Information Set. In adjusted analyses, beneficiaries with IDD had more hospitalizations for ACSC than those without IDD in both insurance groups. Differences in patterns of ACSC prevalence, comorbidities, and hospital admissions between the commercially and Medicaid-insured groups show the value of using all-payer claims data, when possible, to understand health needs and health care utilization of insurance beneficiaries with IDD.

Hospitalizations for Ambulatory Care Sensitive Conditions and Quality of Primary Care

Medical Care ◽  
2011 ◽  
Vol 49 (1) ◽  
pp. 17-23 ◽  
Author(s):  
Purificación Magán ◽  
Ángel Alberquilla ◽  
Ángel Otero ◽  
José Manuel Ribera
Keyword(s):  
Primary Care ◽  
Ambulatory Care ◽  
Ambulatory Care Sensitive Conditions ◽  
Quality Of Primary Care ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

scholarly journals Parameters of the Influenza Epidemic in Russia in the 2019-2020 Season

2021 ◽  
Vol 19 (6) ◽  
pp. 8-17
Author(s):  
L. S. Karpova ◽  
T. P. Stolyarova ◽  
N. M. Popovtseva
Keyword(s):  
School Children ◽  
Early Onset ◽  
Federal District ◽  
Moderate Intensity ◽  
Influenza Epidemic ◽  
North Caucasus ◽  
Epidemic Process ◽  
The Past ◽  
The North ◽  
Federal Districts

Relevance. The National influenza center uses additional criteria: baselines and thresholds for epidemic intensity for early recognition of the onset and assessment of epidemic intensity. Aim. To characterize the parameters of the flu epidemic in the Russian Federation in the 2019-2020 season and assess the intensity of the last 2 epidemics and the effectiveness of baselines and intensity thresholds. Materials and methods. The database of the research Institute of influenza on weekly morbidity, hospitalization, deaths from influenza and ARVI in the cities-reference bases of the National center for influenza was used. The analysis of the flu situation is based on comparing the current incidence of influenza and ARVI with weekly epic thresholds and baselines. A comparative assessment of the intensity of the last 2 influenza epidemics was carried out using intensity thresholds calculated by the moving epidemic method (MEM). Results. The main parameters of the 2019-20 influenza epidemic compared to the previous one are described. There was an increase in the incidence of clinically diagnosed «fluenza» in the pre-epidemic period and the early onset of both epidemics and reaching a peak in the 6th calendar week. This season, the epidemic started among school children, then among adults, and in the past-among the adult population, the incidence of children 0-2 years old was below the thresholds in both epidemics. This season, the average duration of the epidemic and the incidence in cities were higher among school children and adults, and over the entire period of the epidemic, the incidence was higher in all age groups across the country. This season, the epidemic started in the North Caucasus Federal district, its intensity was medium and low, in the past - it started simultaneously in the Siberian, Ural and North Caucasus districts, and its intensity was very high (in the North Caucasus) and high (in the Siberian Federal district) and the average level of 6 districts. The intensity and duration of epidemics were higher in districts with an early onset (in the North Caucasus and Siberian Federal districts). Both epidemics in the country were of moderate intensity, but there were fewer deaths from influenza in the last epidemic. Conclusion. Comparative characteristics of epidemics using baselines and intensity thresholds allowed us to identify the features of the epidemic process in the seasons 2018-19 and 2019-20: the earlier onset of both epidemics; a noticeable increase in the incidence of fluenza before the beginning of epidemics; a decrease in the intensity of epidemics and mortality from influenza; features of the epidemic process in Federal districts. The effectiveness of using additional criteria in the analysis of the influenza epidemic in Russia and this season has been confirmed. In both epidemics, the weekly epidemic thresholds for influenza and ARVI were more sensitive when determining the start of the epidemic, and the end of it, on the contrary, were baselines, and the baselines of morbidity and hospitalization with a diagnosis «influenza» determined the beginning and end of the epidemic even more precisely.

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.

scholarly journals Hospital admissions due to ambulatory care sensitive conditions among children by age group and health region

2015 ◽  
Vol 49 (1) ◽  
pp. 44-53 ◽  
Author(s):  
Kelly Holanda Prezotto ◽  
Maria Marta Nolasco Chaves ◽  
Thais Aidar de Freitas Mathias
Keyword(s):  
Ambulatory Care ◽  
Hospital Admissions ◽  
Age Groups ◽  
Ambulatory Care Sensitive Conditions ◽  
Age Group ◽  
Health Region ◽  
Unified Health System ◽  
Using Data ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

OBJECTIVE to describe hospital admissions for ambulatory care sensitive conditions in children under five years of age in the State of Paraná, Brazil by condition type, age group and health region. METHOD a temporal ecological study was conducted using data from the Unified Health System Hospital Information System for the period 2000 to 2011. Conditions were grouped in accordance with the list of ambulatory care sensitive conditions in Brazil. RESULTS there was an increase in the rate of admissions for ambulatory care sensitive conditions in all age groups in 50% of the health regions, with a marked increase in children under the age of one. Pneumonia, gastroenteritis and asthma were the main causes of admissions. There was an increase in the proportion of overall admissions accounted for by pneumonia and gastroenteritis. CONCLUSION the increase in admissions reveals the need for actions to improve access to primary healthcare and provide effective treatment of the main ambulatory care sensitive conditions in order to prevent hospital admissions among children.

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