Analyzing admission rates for multiple ambulatory care–sensitive conditions

This study assessed rates of ambulatory care-sensitive condition (ACSC) admissions within a healthcare system to identify areas for intervention. This was a multiyear cross-sectional study using the data warehouse of Clalit Health Services (Clalit), the largest payer/provider healthcare system in Is...

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Published in:The American journal of managed care Vol. 26; no. 5; pp. e155 - e161
Main Authors: Leventer-Roberts, Maya, Cohen-Stavi, Chandra, Hoshen, Moshe, Gofer, Ilan, Sherf, Michael, Balicer, Ran
Format: Journal Article
Language:English
Published: United States Intellisphere, LLC 01.05.2020
MultiMedia Healthcare Inc
Subjects:
Ambulatory care
Ambulatory Care - statistics & numerical data
Ambulatory medical care
Cellulitis
Chronic illnesses
Codes
Cross-Sectional Studies
Data warehouses
Disease
Ethnicity
Health care policy
Health services
Heart failure
Hospitalization - statistics & numerical data
Hospitals
Humans
Hypertension
Israel
Medical colleges
Medical records
Outpatient care facilities
Patient admissions
Pneumonia
Primary care
Quality of Health Care
Retrospective Studies
Israel
ISSN:1088-0224, 1936-2692, 1936-2692
Online Access:Get full text
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Summary:This study assessed rates of ambulatory care-sensitive condition (ACSC) admissions within a healthcare system to identify areas for intervention. This was a multiyear cross-sectional study using the data warehouse of Clalit Health Services (Clalit), the largest payer/provider healthcare system in Israel, with complete clinical records for more than 4 million members. All admissions from 2009 to 2014 were included in the study. Discharge diagnoses were identified using International Classification of Diseases, Ninth Revision codes. We provide adjusted rates (per 100,000 Clalit population adjusted by age and sex to the 2005 Organisation for Economic Co-operation and Development population) for all admissions, by discharge diagnoses, for each year. We identify the highest adjusted rates (relative and absolute) by both catchment area and hospital affiliation (Clalit or non-Clalit). ACSC-related admissions made up 16.2% of all admissions for the 5 years studied, and the overall rate increased by 26.8% from 2009 to 2014. The conditions with the highest admission rates in all years and all catchment areas were pneumonia and congestive heart failure. There was extreme variation among catchment areas for hypertension-related admissions. Within the Clalit hospitals, ACSCs accounted for 20.5% of admissions; within non-Clalit hospitals, ACSCs accounted for 13.6% of admissions. In evaluating the rates of ACSC-related admissions, this study demonstrates the contribution of a single, longitudinal benchmark. This study also suggests that hypertension, congestive heart failure, and pneumonia may be areas for future intervention in Clalit.
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ISSN:1088-0224
1936-2692
1936-2692
DOI:10.37765/ajmc.2020.43158