Preventable hospitalizations from ambulatory care sensitive conditions in nursing homes: evidence from Switzerland

Abstract

ObjectivesReducing nursing home hospitalizations for ambulatory care sensitive conditions (ACSC) has been identified as an opportunity to improve patient well-being and reduce costs. The aim of this study was to identify number of hospitalizations for ACSCs for nursing home residents in a Swiss national sample, examine demographic characteristics of nursing home hospitalizations due to ACSCs, and calculate hospital expenses from these hospitalizations.MethodsUsing merged hospital administrative data with payment data based on diagnosis-related groups (DRGs) for the year 2013, we descriptively examined nursing home residents who were 65 years of age or older and were admitted to an acute care hospital.ResultsApproximately 42% of all nursing home admissions were due to ACSCs. Payments to Swiss hospitals for ACSCs can be estimated at between 89 and 105 million Swiss francs in 2013.ConclusionsA sizable share of hospitalizations for nursing home residents is for ACSCs, and the associated costs are substantial. Programs and policies designed to reduce these potentially avoidable hospitalizations from the nursing home setting could lead to an increased patient well-being and lower costs.Electronic supplementary materialThe online version of this article (10.1007/s00038-019-01294-1) contains supplementary material, which is available to authorized users.

Residents’ and Relatives’ Experiences of Acute Situations: A Qualitative Study to Inform a Care Model

“…Considering that any hospitalization typically causes major stress and disruption for residents, leaving them in a more vulnerable state with reduced quality of life, avoidable ones also indicate poor quality of care ( Kirsebom et al, 2014 ; Ouslander et al, 2010 ). Still, estimates indicate that in Canada, the United States, and Switzerland, between 20% and 60% of hospitalizations from NHs are potentially avoidable, for example, due to an exacerbation of a change in condition of a chronic heart disease detected late, or the management of pneumonia or end-of-life care that could have been handled in the NHs ( Muench et al, 2019 ; Ouslander et al, 2010 ; Walker et al, 2009 ).…”

Exploration of Preventable Hospitalizations for Colorectal Cancer with the National Cancer Control Program in Taiwan

“…To reduce the incidence and severity of cancer, the National Cancer Control Program (NCCP) has increased the rate of screening for various types of cancer [1,2]. Initiatives have also begun to improve accessibility to primary care, reduce preventable hospitalizations (PH), reduce the growth of medical expenses, and increase cost efficiency [3][4][5][6].…”

“…Research in the early 1990s focused on the accessibility of primary care, and sought to control costs through defining comparison tables for sensitive outpatient care status [7,15]. In 1993, the US Institute of Medicine (IOM) proposed official standards for immediate and efficient primary care, seeking to minimize incidence of disease, control the deterioration of acute conditions, manage chronic disease, prevent complications, and prevent hospitalizations [5,8,16]. The IOM also proposed using PH as an indicator for the availability and quality of primary care, suggesting that hospitalizations caused by ACSCs indicate nonoptimal primary care quality and access.…”

“…The Health Care Research and Quality Service of the US Department of Health and Human Services (DHSS) defines PH as hospitalizations caused by ACSCs. Many other countries have begun to develop ACSC scales adapted to local conditions [5,17].…”

The economics of patient safety Part III: Long-term care

“…This manifests into potentially significant health and economic burden associated to inappropriate polypharmacy in LTC institutions and older residents for which evidence is generally scarce. Latest figures for the United States refer that 750 older adults are hospitalised due to serious side effects from one or more medications every day, corresponding to 2 million hospital admissions over the last decade (Lown Institute, 2019 [164]). Europe also faces considerable burden of ADEs.…”