Identify Social Determinants of Health Related to Ambulatory Care Sensitive Conditions: Decreasing Hospitalizations and Emergency Department Visits

Abstract

Introduction: Ambulatory care sensitive conditions (ACSCs) have been linked to higher emergency room and hospitalization rates. Research suggests social determinants of health (SDOH) may play a role; however, there is a limited understanding of the relationship between ACSCs and SDOH. This study's objective was to examine the relationship between structural and intermediary SDOH and chronic ACSC status among United States adults (U.S.). Methods: Data were drawn from the 2017 Behavioral Risk Surveillance System for 12 states and U.S. territories that completed the SDOH module (N= 111,828). Descriptive statistics and binary logistic regression analysis identified SDOH associated with a chronic ACSC status. Results: More than 45% of participants had a chronic ACSC. Individuals with ACSCs had higher odds of reporting their neighborhood as unsafe (AOR=1.25; 95%CI=1.05-1.49) than those who reported their neighborhood as extremely safe. Similarly, participants with ACSCs were significantly more likely to report challenges paying their utilities/rent/mortgage (AOR=1.18; 95%CI=1.03-1.36) than to report not experiencing challenges. Conclusions: To address chronic ACSCs, intersectoral public policies are warranted to diminish educational inequalities and racial disparities. This population would also benefit from community-based interventions that connect them to local resources that reduce stress and improve their financial stability and neighborhood safety level.

Social determinants of health and preventable emergency department patient encounters among adults with hypertension

“…Hypertension is one of the most common ambulatory care sensitive conditions (ACSCs) associated with emergency department (ED) patient encounters (Baptiste et al., 2021). Most ED encounters among individuals with ACSCs are preventable through adequate disease management (Gjini et al., 2022), such as having access to resources promoting optimal health outcomes (Baptiste et al., 2021). Limited access can increase ED utilization for conditions often manageable by primary care resulting in increased healthcare costs, overcrowding in emergency departments, and poor patient outcomes as staff and resources are diverted from conditions requiring immediate attention (Fishman et al., 2018).…”