Analyzing admission rates for multiple ambulatory care–sensitive conditions

2020 ◽  
Vol 26 (5) ◽  
pp. e155-e161
2002 ◽  
Vol 25 (2) ◽  
pp. 71 ◽  
Author(s):  
Zahid Ansari ◽  
Norman Carson ◽  
Adrian Serraglio ◽  
Toni Barbetti ◽  
Flavia Cicuttini

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.


2007 ◽  
Vol 122 (3) ◽  
pp. 362-372 ◽  
Author(s):  
Daniel L. Howard ◽  
Farrukh B. Hakeem ◽  
Christopher Njue ◽  
Timothy Carey ◽  
Yhenneko Jallah

Rheumatology ◽  
2021 ◽  
Author(s):  
Ali Kiadaliri ◽  
Martin Englund

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.


BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e028744 ◽  
Author(s):  
Geraldine McDarby ◽  
Breda Smyth

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.


2003 ◽  
Vol 3 (6) ◽  
pp. 324-328 ◽  
Author(s):  
John F. Steiner ◽  
Patricia A. Braun ◽  
Paul Melinkovich ◽  
Judith E. Glazner ◽  
Vijayalaxmi Chandramouli ◽  
...  

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