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.

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.

Education level and hospitalization for ambulatory care sensitive conditions: an education approach is required

2019 ◽  
Vol 30 (2) ◽  
pp. 207-212 ◽  
Author(s):  
Alessandra Buja ◽  
Marco Fonzo ◽  
Milena Sperotto ◽  
Elisa De Battisti ◽  
Tatjana Baldovin ◽  
...  
Keyword(s):  
Health Care ◽  
Ambulatory Care ◽  
Formal Education ◽  
Hospital Admissions ◽  
Healthcare Services ◽  
Healthcare Research ◽  
Ambulatory Care Sensitive Conditions ◽  
Educational Approach ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Abstract Background Studies in several different countries and settings suggest that ambulatory care–sensitive conditions (ACSCs)-related hospitalizations could be associated more with socioeconomic variables than with the quality of primary healthcare services. The aim of the present study was to analyze the potential links between education levels or other social determinants and ACSC-related hospitalization rates. Methods We analyzed a total of 467 504 records of ordinary discharges after acute hospitalization in 2015–16 for patients 20–74 years old residing in the Veneto Region. We calculated the prevention quality indicators (PQIs) developed by the Agency for Healthcare Research and Quality. Rate ratios (RRs) and 95% confidence intervals (95% CIs) were estimated with a set of Poisson regressions to measure the relative risk by sociodemographic level. Results Hospitalizations for ACSCs accounted for 3.9% of all hospital admissions (18 436 discharges), and the crude hospitalization rate for ACSCs among 20- to 74-year-olds was 26.6 per 10 000 inhabitants (95% CI, 25.8–27.4). For all conditions, we found a significant association with formal education. In the case of the overall composite PQI#90, e.g. poorly educated people (primary school or no schooling) were at significantly higher risk of hospitalization for ACSCs than the better educated (RR, 4.50; 95% CI, 4.13–4.91). Conclusions Currently available administrative data regarding ACSCs may be used effectively for reveal equity issues in the provision of health care. Our results indicate that an educational approach inside Primary Health Care could address the extra risk for preventable healthcare demands associated with poorly educated patients.

scholarly journals The Impact of Medicaid Managed Care on Hospitalizations for Ambulatory Care Sensitive Conditions

2005 ◽  
Vol 40 (1) ◽  
pp. 19-38 ◽  
Author(s):  
Andrew B. Bindman ◽  
Arpita Chattopadhyay ◽  
Dennis H. Osmond ◽  
William Huen ◽  
Peter Bacchetti
Keyword(s):  
Managed Care ◽  
Ambulatory Care ◽  
Ambulatory Care Sensitive Conditions ◽  
Medicaid Managed Care ◽  
The Impact ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

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 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 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.

Sign in / Sign up

Export Citation Format

Share Document