scholarly journals Hospital Admission Rates for Ambulatory Care Sensitive Conditions in South Korea: Could It Be Used as an Indicator for Measuring Efficiency of Healthcare Utilization?

2016 ◽  
Vol 26 (1) ◽  
pp. 4-11
Author(s):  
Keon-Jak Jeong ◽  
Jinkyung Kim ◽  
Hye-Young Kang ◽  
Euichul Shin
Keyword(s):  
South Korea ◽  
Hospital Admission ◽  
Ambulatory Care ◽  
Healthcare Utilization ◽  
Ambulatory Care Sensitive Conditions ◽  
Admission Rates ◽  
Measuring Efficiency ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

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.

scholarly journals Racially Disproportionate Admission Rates for Ambulatory Care Sensitive Conditions in North Carolina

2007 ◽  
Vol 122 (3) ◽  
pp. 362-372 ◽  
Author(s):  
Daniel L. Howard ◽  
Farrukh B. Hakeem ◽  
Christopher Njue ◽  
Timothy Carey ◽  
Yhenneko Jallah
Keyword(s):  
North Carolina ◽  
Ambulatory Care ◽  
Ambulatory Care Sensitive Conditions ◽  
Admission Rates ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

scholarly journals Determining when a hospital admission of an older person can be avoided in a subacute setting: a systematic review and concept analysis

2019 ◽  
Vol 25 (4) ◽  
pp. 252-264
Author(s):  
Alyson L Huntley ◽  
Ben Davies ◽  
Nigel Jones ◽  
James Rooney ◽  
Peter Goyder ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hospital Admission ◽  
Ambulatory Care ◽  
Concept Analysis ◽  
Ambulatory Care Sensitive Conditions ◽  
Older Person ◽  
Definition Of ◽  
Tract Infections ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Objective To conduct a systematic review of the evidence for when a hospital admission for an older person can be avoided in subacute settings. We examined the definition of admission avoidance and the evidence for the factors that are required to avoid admission to hospital in this setting. Methods Using defined PICOD criteria, we conducted searches in three databases (Medline, Embase and Cinahl) from January 2006 to February 2018. References were screened by title and abstract followed by full paper screening by two reviewers. Additional studies were searched from the grey literature, experts in the field and forward and backward referencing. Data were narratively described, and concept analysis was used to investigate the definition of admission avoidance. Results A total of 17 studies were considered eligible for review; eight provided a definition of admission avoidance and 10 described admission avoidance criteria. We identified three factors which play a key role in admission avoidance in the subacute setting: (1) ambulatory care sensitive conditions and common medical scenarios for the older person, which included respiratory infections or pneumonia, urinary tract infections and catheter care, dehydration and associated symptoms, falls and behavioural management, and managing ongoing chronic conditions; (2) criteria/tools, referring to interventions that have used clinical expertise in conjunction with a range of general and geriatric triage tools; in condition-specific interventions, the decision whether to admit or not was based on level of risk determined by defined clinical tools; and (3) personnel and resources, referring to the need for experts to make the initial decision to avoid an admission. Supervision by nurses or physicians was still needed at subacute level, requiring resources such as short-stay beds, intravenous antibiotic treatment or fluids for rehydration and rapid access to laboratory tests. Conclusion The review identified a set of criteria for ambulatory care sensitive conditions and common medical scenarios for the older person that can be treated in the subacute setting with appropriate tools and resources. This information can help commissioners and care providers to take on these important elements and deliver them in a locally designed way.

scholarly journals Current Status of Repeated Hospitalization in South Korea: Focused on Ambulatory Care Sensitive Conditions

2021 ◽  
Vol 27 (2) ◽  
pp. 45-56
Author(s):  
Hyemin Jung ◽  
Hyun Joo Kim ◽  
Jin Yong Lee
Keyword(s):  
South Korea ◽  
Ambulatory Care ◽  
Patient Characteristics ◽  
Medical Expenditure ◽  
Current Status ◽  
Ambulatory Care Sensitive Conditions ◽  
Hospital Days ◽  
Information Database ◽  
Ambulatory Care Sensitive ◽  
Sensitive Conditions

Purpose: Repeated hospitalization could be a proxy of unnecessary or preventive admission in South Korea where barriers to hospitalization are relatively low. This study aimed to estimate the current status of repeated hospitalization due to ambulatory care sensitive conditions (ACSC) in South Korea.Methods: Using the National Health Information Database, repeated hospitalization databases were constructed in units of episodes for patients who had been admitted more than twice between January 2017 and December 2018. The number of hospitalizations, total in-hospital days, and total medical expenditure were calculated and compared by patient characteristics in both of the entire patient group and the ACSC patient group.Results: Of total hospitalization episodes, 26.6% reported repeated admission, and 6.7% of repeated hospitalization was due to ACSC. A total of 183,110 patients with ACSC had been admitted an average of 2.9 times and spent an average of KRW5,630,118. In other words, KRW1,309 billion had been spent for repeated hospitalization due to ACSC. The scale of medical expenditure was relatively large in the highest and lowest socioeconomic status.Conclusion: Repeated hospitalization for ACSC can be considered a simple and intuitive indicator when assessing unnecessary hospitalizations or evaluating healthcare policy.

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.

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