Admissions for chronic ambulatory care sensitive conditions - a useful measure of potentially preventable admission?

Longman, Jo; Passey, Megan; Ewald, Dan; Rix, Elizabeth F; Morgan, Geoffrey G.

doi:10.1186/s12913-015-1137-0

Cited by 62 publications

(74 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…While many admissions could have been prevented through effective chronic disease management in the primary care setting, other admissions may re ect necessary admissions for seriously ill patients. [32] Secondly, national hospital records are likely to under-report Aboriginal status and it is likely that the true numbers of avoidable admissions and their frequency among Aboriginal people are higher than reported in this study. [33]…”

Section: Limitationsmentioning

confidence: 83%

Frequent avoidable admissions amongst Aboriginal and non-Aboriginal people with chronic disease in New South Wales, Australia: a retrospective cohort study

Jayakody¹,

Oldmeadow²,

Carey³

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Aboriginal and Torres Strait Islander people have high rates of avoidable hospital admissions for chronic diseases, however little is known about the frequency of avoidable admissions for this population. This study aimed to examine trends in avoidable admissions among Aboriginal and non-Aboriginal people with ambulatory care sensitive chronic conditions in New South Wales (NSW), Australia. Methods: A retrospective cohort analysis using de-identified linked administrative data of Aboriginal and non-Aboriginal patients between 2005/06 to 2013/14. Eligible patients were admitted to a NSW public hospital and who had one or more of the following ambulatory care sensitive chronic conditions as a principal diagnosis: diabetic complications, asthma, angina, hypertension, congestive heart failure and/or chronic obstructive pulmonary disease. The primary outcomes were the number of avoidable admissions for an individual in each financial year, and whether an individual had three or more admissions compared with one to two avoidable admissions in each financial year. Poisson and logistic regression models and a test for differences in yearly trends were used to assess the frequency of avoidable admissions over time, adjusting for sociodemographic variables and restricted to those aged ≤75 years.Results: There were a total of 27,467 avoidable admissions corresponding to 19,025 patients over the nine-year period (71.2% Aboriginal; 28.8% non-Aboriginal). Aboriginal patients were 15% more likely than non-Aboriginal patients to have a higher number of avoidable admissions per financial year (IRR=1.15; CI: 1.11, 1.20). Aboriginal patients were almost twice as likely as non-Aboriginal patients to experience three or more avoidable admissions per financial year (OR=1.90; CI=1.60, 2.26). There were no significant differences between Aboriginal and non-Aboriginal people in yearly trends for either the number of avoidable admissions, or whether or not an individual experienced three or more avoidable admissions per financial year (p=0.8599; 0.8608 respectively). Conclusion: Aboriginal people were significantly more likely to experience frequent avoidable admissions over a nine-year period compared to non-Aboriginal people. These high rates reflect the need for further research into which interventions are able to successfully reduce avoidable admissions among Aboriginal people with chronic diseases, and the importance of culturally appropriate early prevention and community health care.

show abstract

Section: Limitationsmentioning

confidence: 83%

Frequent avoidable admissions amongst Aboriginal and non-Aboriginal people with chronic disease in New South Wales, Australia: a retrospective cohort study

Jayakody¹,

Oldmeadow²,

Carey³

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Persistently high rates of dental-related hospital admissions have been used by government agencies and researchers as indicators of the quality or effectiveness of non-hospital care (Duckett 2016; Australian Institute of Health and Welfare 2013; National Health Performance Authority 2015; COAG Health Council 2015; Caffery et al 2017;Coles et al 2017). The identification of priority areas for place-based interventions is a complex topic that varies between health systems and health conditions (Longman et al 2015). However, this analysis demonstrates that high rates of dental-related hospital admissions do not necessarily reflect poor access to dental services, whether such access is measured in financial or geographic terms, and ED presentations are also limited indicators of such access.…”

Section: Discussionmentioning

confidence: 99%

Hospital admissions and emergency department presentations for dental conditions indicate access to hospital, rather than poor access to dental health care in the community

Yap

Kok

Nanda

et al. 2018

Aust. J. Prim. Health

View full text Add to dashboard Cite

High rates of dental-related potentially preventable hospitalisations are thought to reflect poor access to non-hospital dental services. The association between accessibility (geographic and financial) to non-hospital dentists and potentially preventable hospitalisations was examined in Western Australia. Areas with persistently high rates of dental-related potentially preventable hospitalisations and emergency department (ED) presentations were mapped. Statistical models examined factors associated with these events. Persistently high rates of dental-related potentially preventable hospitalisations were clustered in metropolitan areas that were socioeconomically advantaged and had more dentists per capita (RR 1.06, 95% CI 1.04-1.08) after adjusting for age, sex, socioeconomics, and Aboriginality. Persistently high rates of ED presentations were clustered in socioeconomically disadvantaged areas near metropolitan EDs and with fewer dentists per capita (RR 0.91, 0.88-0.94). A positive association between dental-related potentially preventable hospitalisations and poor (financial or geographic) access to dentists was not found. Rather, rates of such events were positively associated with socioeconomic advantage, plus greater access to hospitals and non-hospital dental services. Furthermore, ED presentations for dental conditions are inappropriate indicators of poor access to non-hospital dental services because of their relationship with hospital proximity. Health service planners and policymakers should pursue alternative indicators of dental service accessibility.

show abstract

“…Some studies have questioned the use of ACSCs as a performance indicator in the individual perspective, as they have found low agreement between what is considered avoidable by the lists and by case reviews performed by specialists 25 . It has been suggest that the association between ACSC and PHC is not as clear as previously described, which may hinder its use as a performance indicator [25][26][27] . In the macro perspective for comparative studies, the variation of crude ACSC rates between regions can be influenced 6,19,23,28,29 .…”

Section: Background About Ambulatory Care Sensitive Conditionsmentioning

confidence: 94%

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

Rocha

Sarmento

Moita

et al. 2020

Ciênc. saúde coletiva

View full text Add to dashboard Cite

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.

show abstract

Admissions for chronic ambulatory care sensitive conditions - a useful measure of potentially preventable admission?

Cited by 62 publications

References 27 publications

Frequent avoidable admissions amongst Aboriginal and non-Aboriginal people with chronic disease in New South Wales, Australia: a retrospective cohort study

Frequent avoidable admissions amongst Aboriginal and non-Aboriginal people with chronic disease in New South Wales, Australia: a retrospective cohort study

Hospital admissions and emergency department presentations for dental conditions indicate access to hospital, rather than poor access to dental health care in the community

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

Contact Info

Product

Resources

About