Relevant bibliographies by topics / Ambulatory sensitive hospitalisations

Academic literature on the topic 'Ambulatory sensitive hospitalisations'

Author: Grafiati
Published: 10 December 2022
Last updated: 28 January 2023

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Journal articles on the topic "Ambulatory sensitive hospitalisations"

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Partanen, Veli-Matti, Martti Arffman, Kristiina Manderbacka, and Ilmo Keskimäki. "Mortality related to ambulatory care sensitive hospitalisations in Finland." Scandinavian Journal of Public Health 48, no. 8 (August 5, 2020): 839–46. http://dx.doi.org/10.1177/1403494820944722.

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Aims: Hospitalisations for ambulatory care sensitive conditions are used as an outcome indicator of access to and quality of primary care. Evidence on mortality related to these hospitalisations is scarce. This study analysed the effect of ambulatory care sensitive condition hospitalisations to subsequent mortality and time or geographical trends in the mortality indicating variations in ambulatory care sensitive conditions outcomes. Methods: This retrospective cohort study used individual-level data from national registers concerning ambulatory care sensitive condition hospitalisations. Crude and age-adjusted 365-day mortality rates for the first ambulatory care sensitive condition-related admission were calculated for vaccine-preventable, acute, and chronic ambulatory care sensitive conditions separately, and for three time periods stratified by gender. The mortality rates were also compared to mortality in the general Finnish population to assess the excess mortality related to ambulatory care sensitive condition hospitalisations. Results: The data comprised a total of 712,904 ambulatory care sensitive condition hospital admissions with the crude 365-day mortality rate of 14.2 per 100 person-years. Mortality for those hospitalised for vaccine-preventable conditions was approximately 10-fold compared to the general population and four-fold in chronic and acute conditions. Of the 10 most common ambulatory care sensitive conditions, bacterial pneumonia and influenza and congestive heart failure were associated with highest age-standardised mortality rates. Conclusions: Hospitalisations for ambulatory care sensitive conditions were shown to be associated with excess mortality in patients compared to the general population. Major differences in mortality were found between different types of ambulatory care sensitive condition admissions. There were also minor differences in mortality between hospital districts. These differences are important to consider when using preventable hospital admissions as an indicator of primary care performance.
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Pongiglione, Benedetta, Aleksandra Torbica, and Michael K. Gusmano. "Inequalities in avoidable hospitalisation in large urban areas: retrospective observational study in the metropolitan area of Milan." BMJ Open 10, no. 12 (December 2020): e042424. http://dx.doi.org/10.1136/bmjopen-2020-042424.

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ObjectiveSignificant inequalities in access to healthcare system exist between residents of world megacities, even if they have different healthcare systems. The aim of this study was to estimate avoidable hospitalisations in the metropolitan area of Milan (Italy) and explore inequalities in access to healthcare between patients and across their areas of residence.DesignRetrospective observational study.SettingPublic and accredited private hospitals in the metropolitan area of Milan. Data obtained from the hospital discharge database of the Italian Health Ministry.Participants472 579 patients hospitalised for ambulatory care sensitive conditions and resident in the metropolitan area of Milan from 2005 to 2016.Outcome measureAge-adjusted rates of avoidable hospitalisations; OR for hospital admissions with ambulatory care sensitive conditions.MethodsAge-adjusted rates of avoidable hospitalisations in the metropolitan area of Milan were estimated from 2005 to 2016 using direct standardisation. For the hospitalised population, multilevel logistic regression model with patient random effects was used to identify patients, hospitals and municipalities’ characteristics associated with risk of avoidable hospitalisation in the period 2012–2016.ResultsThe rate of avoidable hospitalisation in Milan fell steadily between 2005 and 2016 from 16.6 to 10.5 per 1000. Among the hospitalised population, the odds of being hospitalised with an ambulatory care sensitive condition was higher for male (OR 1.42, 95% CI 1.36 to 1.48), older (OR 1.012, 95% CI 1.01 to 1.014), low-educated (elementary school vs degree OR 4.23, 95% CI 3.72 to 4.81) and single (vs married OR 2.08, 95% CI 2.01 to 2.16) patients with comorbidities (OR 1.47, 95% CI 1.38 to 1.56); avoidable admissions were more frequent in public non-teaching hospitals while municipality’s characteristics did not appear to be correlated with hospitalisation for ambulatory care sensitive conditions.ConclusionsThe health system in metropolitan Milan has experienced a reduction in avoidable hospitalisations between 2005 and 2016, quite homogeneously across its 134 municipalities. The study design allowed to explore inequalities among the hospitalised population for which we found specific sociodemographic disadvantages.
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Yi, Seung Eun, Vinyas Harish, Jahir Gutierrez, Mathieu Ravaut, Kathy Kornas, Tristan Watson, Tomi Poutanen, Marzyeh Ghassemi, Maksims Volkovs, and Laura C. Rosella. "Predicting hospitalisations related to ambulatory care sensitive conditions with machine learning for population health planning: derivation and validation cohort study." BMJ Open 12, no. 4 (April 2022): e051403. http://dx.doi.org/10.1136/bmjopen-2021-051403.

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ObjectiveTo predict older adults’ risk of avoidable hospitalisation related to ambulatory care sensitive conditions (ACSC) using machine learning applied to administrative health data of Ontario, Canada.Design, setting and participantsA retrospective cohort study was conducted on a large cohort of all residents covered under a single-payer system in Ontario, Canada over the period of 10 years (2008–2017). The study included 1.85 million Ontario residents between 65 and 74 years old at any time throughout the study period.Data sourcesAdministrative health data from Ontario, Canada obtained from the (ICES formely known as the Institute for Clinical Evaluative Sciences Data Repository.Main outcome measuresRisk of hospitalisations due to ACSCs 1 year after the observation period.ResultsThe study used a total of 1 854 116 patients, split into train, validation and test sets. The ACSC incidence rates among the data points were 1.1% for all sets. The final XGBoost model achieved an area under the receiver operating curve of 80.5% and an area under precision–recall curve of 0.093 on the test set, and the predictions were well calibrated, including in key subgroups. When ranking the model predictions, those at the top 5% of risk as predicted by the model captured 37.4% of those presented with an ACSC-related hospitalisation. A variety of features such as the previous number of ambulatory care visits, presence of ACSC-related hospitalisations during the observation window, age, rural residence and prescription of certain medications were contributors to the prediction. Our model was also able to capture the geospatial heterogeneity of ACSC risk in Ontario, and especially the elevated risk in rural and marginalised regions.ConclusionsThis study aimed to predict the 1-year risk of hospitalisation from ambulatory-care sensitive conditions in seniors aged 65–74 years old with a single, large-scale machine learning model. The model shows the potential to inform population health planning and interventions to reduce the burden of ACSC-related hospitalisations.
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Vuik, Sabine I., Gianluca Fontana, Erik Mayer, and Ara Darzi. "Do hospitalisations for ambulatory care sensitive conditions reflect low access to primary care? An observational cohort study of primary care usage prior to hospitalisation." BMJ Open 7, no. 8 (August 2017): e015704. http://dx.doi.org/10.1136/bmjopen-2016-015704.

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ObjectivesTo explore whether hospitalisations for ambulatory care sensitive conditions (ACSCs) are associated with low access to primary care.DesignObservational cohort study over 2008 to 2012 using the Clinical Practice Research Datalink (CPRD) and Hospital Episode Statistics (HES) databases.SettingEnglish primary and secondary care.ParticipantsA random sample of 300 000 patients.Main outcome measuresEmergency hospitalisation for an ACSC.ResultsOver the long term, patients with ACSC hospitalisations had on average 2.33 (2.17 to 2.49) more general practice contacts per 6 months than patients with similar conditions who did not require hospitalisation. When accounting for the number of diagnosed ACSCs, age, gender and GP practice through a nested case–control method, the difference was smaller (0.64 contacts), but still significant (p<0.001).In the short-term analysis, measured over the 6 months prior to hospitalisation, patients used more GP services than on average over the 5 years. Cases had significantly (p<0.001) more primary care contacts in the 6 months before ACSC hospitalisations (7.12, 95% CI 6.95 to 7.30) than their controls during the same 6 months (5.57, 95% CI 5.43 to 5.72). The use of GP services increased closer to the time of hospitalisation, with a peak of 1.79 (1.74 to 1.83) contacts in the last 30 days before hospitalisation.ConclusionsThis study found no evidence to support the hypothesis that low access to primary care is the main driver of ACSC hospitalisations. Other causes should also be explored to understand how to use ACSC admission rates as quality metrics, and to develop the appropriate interventions.
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Hildebrandt, Helmut, and Timo Schulte. "Reducing Hospitalisations for Ambulatory Care-sensitive Conditions in Integrated Care Systems." International Journal of Integrated Care 17, no. 5 (October 17, 2017): 314. http://dx.doi.org/10.5334/ijic.3631.

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Sheridan, A., F. Howell, and D. Bedford. "Hospitalisations and costs relating to ambulatory care sensitive conditions in Ireland." Irish Journal of Medical Science 181, no. 4 (March 8, 2012): 527–33. http://dx.doi.org/10.1007/s11845-012-0810-0.

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Wilk, Piotr, Shehzad Ali, Kelly K. Anderson, Andrew F. Clark, Martin Cooke, Stephanie J. Frisbee, Jason Gilliland, et al. "Geographic variation in preventable hospitalisations across Canada: a cross-sectional study." BMJ Open 10, no. 5 (May 2020): e037195. http://dx.doi.org/10.1136/bmjopen-2020-037195.

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ObjectiveThe objective of this study is to examine the magnitude and pattern of small-area geographic variation in rates of preventable hospitalisations for ambulatory care-sensitive conditions (ACSC) across Canada (excluding Québec).Design and settingA cross-sectional study conducted in Canada (excluding Québec) using data from the 2006 Canadian Census Health and Environment Cohort (CanCHEC) linked prospectively to hospitalisation records from the Discharge Abstract Database (DAD) for the three fiscal years: 2006–2007, 2007–2008 and 2008–2009.Primary outcome measurePreventable hospitalisations (ACSC).ParticipantsThe 2006 CanCHEC represents a population of 22 562 120 individuals in Canada (excluding Québec). Of this number, 2 940 150 (13.03%) individuals were estimated to be hospitalised at least once during the 2006–2009 fiscal years.MethodsAge-standardised annualised ACSC hospitalisation rates per 100 000 population were computed for each of the 190 Census Divisions. To assess the magnitude of Census Division-level geographic variation in rates of preventable hospitalisations, the global Moran’s I statistic was computed. ‘Hot spot’ analysis was used to identify the pattern of geographic variation.ResultsOf all the hospitalisation events reported in Canada during the 2006–2009 fiscal years, 337 995 (7.10%) events were ACSC-related hospitalisations. The Moran’s I statistic (Moran’s I=0.355) suggests non-randomness in the spatial distribution of preventable hospitalisations. The findings from the ‘hot spot’ analysis indicate a cluster of Census Divisions located in predominantly rural and remote parts of Ontario, Manitoba and Saskatchewan and in eastern and northern parts of Nunavut with significantly higher than average rates of preventable hospitalisation.ConclusionThe knowledge generated on the small-area geographic variation in preventable hospitalisations can inform regional, provincial and national decision makers on planning, allocation of resources and monitoring performance of health service providers.
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Russo, Letícia Xander, Timothy Powell-Jackson, Jorge Otavio Maia Barreto, Josephine Borghi, Roxanne Kovacs, Garibaldi Dantas Gurgel Junior, Luciano Bezerra Gomes, et al. "Pay for performance in primary care: the contribution of the Programme for Improving Access and Quality of Primary Care (PMAQ) on avoidable hospitalisations in Brazil, 2009–2018." BMJ Global Health 6, no. 7 (July 2021): e005429. http://dx.doi.org/10.1136/bmjgh-2021-005429.

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BackgroundEvidence on the effect of pay-for-performance (P4P) schemes on provider performance is mixed in low-income and middle-income countries. Brazil introduced its first national-level P4P scheme in 2011 (PMAQ-Brazilian National Programme for Improving Primary Care Access and Quality). PMAQ is likely one of the largest P4P schemes in the world. We estimate the association between PMAQ and hospitalisations for ambulatory care sensitive conditions (ACSCs) based on a panel of 5564 municipalities.MethodsWe conducted a fixed effect panel data analysis over the period of 2009–2018, controlling for coverage of primary healthcare, hospital beds per 10 000 population, education, real gross domestic product per capita and population density. The outcome is the hospitalisation rate for ACSCs among people aged 64 years and under per 10 000 population. Our exposure variable is defined as the percentage of family health teams participating in PMAQ, which captures the roll-out of PMAQ over time. We also provided several sensitivity analyses, by using alternative measures of the exposure and outcome variables, and a placebo test using transport accident hospitalisations instead of ACSCs.ResultsThe results show a negative and statistically significant association between the rollout of PMAQ and ACSC rates for all age groups. An increase in PMAQ participating of one percentage point decreased the hospitalisation rate for ACSC by 0.0356 (SE 0.0123, p=0.004) per 10 000 population (aged 0–64 years). This corresponds to a reduction of approximately 60 829 hospitalisations in 2018. The impact is stronger for children under 5 years (−0.0940, SE 0.0375, p=0.012), representing a reduction of around 11 936 hospitalisations. Our placebo test shows that the association of PMAQ on the hospitalisation rate for transport accidents is not statistically significant, as expected.ConclusionWe find that PMAQ was associated with a modest reduction in hospitalisation for ACSCs.
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Lugo-Palacios, David G., and John Cairns. "The financial and health burden of diabetic ambulatory care sensitive hospitalisations in Mexico." Salud Pública de México 58, no. 2 (March 2016): 33–40. http://dx.doi.org/10.21149/spm.v58i1.7665.

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De Prophetis, Eric, Vivek Goel, Tristan Watson, and Laura C. Rosella. "Relationship between life satisfaction and preventable hospitalisations: a population-based cohort study in Ontario, Canada." BMJ Open 10, no. 2 (February 2020): e032837. http://dx.doi.org/10.1136/bmjopen-2019-032837.

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ObjectiveTo examine if low life satisfaction is associated with an increased risk of being hospitalised for an ambulatory care sensitive condition (ACSC), in comparison to high life satisfactionDesign and settingPopulation-based cohort study of adults from Ontario, Canada. Baseline data were captured through the Canadian Community Health Survey (CCHS) and linked to health administrative data for follow-up information.Participants129 467 men and women between the ages 18 and 74.Main outcome measuresTime to avoidable hospitalisations defined by ACSCs.ResultsLife satisfaction was measured at baseline through the CCHS and follow-up information on ACSC hospitalisations were captured by linking participant respondents to hospitalisation records covered under a single payer health system. Within the study time frame (maximum of 14 years), 3037 individuals were hospitalised. Older men in the lowest household income quintile were more likely to be hospitalised with an ACSC. After controlling for age, sex, socioeconomic status (SES) and other behavioural factors, low life satisfaction at baseline had a strong relationship with future hospitalisations for ACSCs (HR 2.71; 95% CI 1.87 to 3.93). The hazards were highest for those who jointly had the lowest levels of life satisfaction and low household income (HR 3.80; 95% CI 2.13 to 6.73). Results did not meaningful change after running a competing risk survival analysis.ConclusionsThis study demonstrates that poor life satisfaction is associated with hospitalisations for ACSCs after adjustment for several confounders. Furthermore, the magnitude of this relationship was greater for those who were more socioeconomically disadvantaged. This study adds to the existing literature on the impact of life satisfaction on health system outcomes by documenting its impact on avoidable hospitalisations in a universal health system.
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Dissertations / Theses on the topic "Ambulatory sensitive hospitalisations"

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Prud'homme, Geneviève. "Linking Preventable Hospitalisation Rates to Neighbourhood Characteristics within Ottawa." Thèse, Université d'Ottawa / University of Ottawa, 2012. http://hdl.handle.net/10393/23136.

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Enhancing primary care is key to the Canadian health care reform. Considered as an indicator of primary care access and quality, hospitalisations for ambulatory care sensitive (ACS) conditions are commonly reported by Canadian organisations as sentinel events signaling problems with the delivery of primary care. However, the literature calls for further research to identify what lies behind ACS hospitalisation rates in regions with a predominantly urban population benefiting from universal access to health care. A theoretical model was built and, using an ecological design, multiple regressions were implemented to identify which neighbourhood characteristics explained the socio-economic gradient in ACS hospitalisation rates observed in Ottawa. Among these neighbourhoods, healthy behaviour and - to a certain extent - health status were significantly associated with ACS hospitalisation rates. Evidence of an association with primary care accessibility was also signaled for the more rural neighbourhoods. Smoking prevention and cessation campaigns may be the most relevant health care strategies to push forward by policy makers hoping to prevent ACS hospitalisations in Ottawa. From a health care equity perspective, targeting these campaigns to neighbourhoods of low socio-economic status may contribute to closing the gap in ACS hospitalisations described in this current study. Reducing the socio-economic inequalities of neighbourhoods would also contribute to health equity.
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Zhou, Haiyun, and 周海韵. "Risk factors driving ambulatory care sensitive conditions hospitalisation among elderly with chronic obstructive pulmonarydisease or heart disease." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2011. http://hub.hku.hk/bib/B47055819.

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Books on the topic "Ambulatory sensitive hospitalisations"

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Atlas of avoidable hospitalisations in Australia: Ambulatory care-sensitive conditions. Adelaide, S. Aust: Public Health Information Development Unit, 2007.

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