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Hospitalization for Ambulatory Care-Sensitive Conditions: A Method for Comparative Access and Quality Studies Using Routinely Collected Statistics

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Abstract

Background: Appropriate and timely provision of ambulatory care is an important factor in maintaining population health and in avoiding unnecessary hospital use. This article describes conditions for which hospitalization rates have a strong and inverse relationship to access to high-quality ambulatory care.

Methods: Three panels of Canadian physicians following different consensus techniques selected conditions for which the relative risk of hospitalization is inversely related to ambulatory care access.

Principal Findings: All panels identified asthma, angina pectoris, congestive heart failure, otitis media, gastric ulcer, pelvic inflammatory disease, malignant hypertension, and immunizationpreventable infections as ambulatory caresensitive admissions. These conditions strongly overlap with lists developed for similar purposes in the U.S. and England.

Interpretation: Ambulatory care-sensitive conditions represent an intermediate health outcome. They are distinct from inappropriate hospitalizations. They may be useful for measuring the impact of health care policy, and for performance measurement or audit.

Résumé

Contexte: La prestation individualisée et opportune de soins ambulatoires est un facteur important pour maintenir la santé de la population et éviter les séjours inutiles à l’hôpital. Notre article décrit les états de santé dont les taux d’hospitalisation présentent une forte relation inverse avec l’accès à des soins ambulatoires de haute qualité.

Méthode: Trois groupes de médecins canadiens suivant différentes techniques de concertation ont sélectionné les états de santé dont le risque relatif d’hospitalisation était en relation inverse avec l’accès aux soins ambulatoires.

Principales constatations: Les trois groupes ont déterminé que les admissions de cas d’asthme, d’angine de poitrine, d’insuffisance cardiaque globale, d’otite moyenne, d’ulcère gastrique, d’infection pelvienne, d’hypertension artérielle maligne et d’infections évitables par la vaccination étaient sensibles aux soins ambulatoires. Cette liste présente d’importants recoupements avec celles dressées aux États- Unis et en Angleterre.

Interprétation: Les états de santé sensibles aux soins ambulatoires sont à classer parmi les résultats de santé à moyen terme. Il faut les distinguer des hospitalisations inutiles. Ils peuvent servir à mesurer les incidences des politiques de soins de santé, ainsi qu’à des fins de vérification ou de mesure du rendement.

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Authors and Affiliations

  1. Department of Public Health and Primary Care, University of Oxford, UK

    Adalsteinn D. Brown AB, Michael J. Goldacre MB & Nicholas Hicks MB

  2. Unit of Health-Care Epidemiology, University of Oxford, UK

    Michael J. Goldacre MB

  3. Department of Family Medicine, University of Western Ontario, Canada

    James T. Rourke MD, MSc

  4. Department of Surgery, University of Western Ontario, Canada

    Robert Y. McMurtry MD

  5. Department of Clinical Neurological Sciences, University of Western Ontario, Canada

    John D. Brown MD, PhD

  6. Department of Health Administration, University of Toronto, 2nd Floor, McMurrich Building, 12 Queen’s Park Circle West, Toronto, ON, M5S 1A8, Canada

    Geoffrey M. Anderson MD, PhD

  7. Institute of Clinical Evaluative Sciences, Sunnybrook Hospital, Toronto, Canada

    Geoffrey M. Anderson MD, PhD

Authors
  1. Adalsteinn D. Brown AB
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  2. Michael J. Goldacre MB
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  3. Nicholas Hicks MB
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  4. James T. Rourke MD, MSc
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  5. Robert Y. McMurtry MD
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  6. John D. Brown MD, PhD
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  7. Geoffrey M. Anderson MD, PhD
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Correspondence to Adalsteinn D. Brown AB.

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Brown, A.D., Goldacre, M.J., Hicks, N. et al. Hospitalization for Ambulatory Care-Sensitive Conditions: A Method for Comparative Access and Quality Studies Using Routinely Collected Statistics. Can J Public Health 92, 155–159 (2001). https://doi.org/10.1007/BF03404951

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  • DOI: https://doi.org/10.1007/BF03404951

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