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 |
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| Main Authors: | , , , , , |
| Format: | Journal Article |
| Language: | English |
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United States
Intellisphere, LLC
01.05.2020
MultiMedia Healthcare Inc |
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| ISSN: | 1088-0224, 1936-2692, 1936-2692 |
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| Abstract | 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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| AbstractList | 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. Objectives: This study assessed rates of ambulatory care–sensitive condition (ACSC) admissions within a healthcare system to identify areas for intervention. Study Design: 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. Methods: 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). Results: 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. Conclusions: 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. This study assessed rates of ambulatory care-sensitive condition (ACSC) admissions within a healthcare system to identify areas for intervention.OBJECTIVESThis 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.STUDY DESIGNThis 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).METHODSWe 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.RESULTSACSC-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.CONCLUSIONSIn 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. Study Design: 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. Several coding methods in various countries have been proposed to create standardized rates,7,11,29-31 including in England,32 Ireland,33 and Italy,34 as well as by the Organisation for Economic Co-operation and Development (OECD)31 and the Agency for Healthcare Research and Quality.30 The most comprehensive taxonomy study outlines the most commonly defined 19 conditions, divided into acute and chronic, and lists the specific International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes associated with each condition.29 In this study, we report on ACSC-related admissions within a healthcare system that integrates inpatient and outpatient services so that we can identify areas that can potentially benefit from further investigation of the primary care services. METHODS Setting This was a retrospective cross-sectional study using the data warehouse of Clalit Health Services (Clalit), a payer/provider health fund covering more than 53% of Israeli residents. There is minimal attrition (~1%) among the 4 major health funds in Israel, resulting in low loss to follow-up within the electronic health record system.35,36 As such, Clalit's data warehouse contains highly comprehensive clinical and administrative records for its more than 4.5 million members. [...]the records maintained by the system include those of both inpatient and outpatient services, as well as of ancillary services such as pharmacies, laboratories, and imaging. |
| Audience | Professional Academic |
| Author | Balicer, Ran Cohen-Stavi, Chandra Sherf, Michael Leventer-Roberts, Maya Gofer, Ilan Hoshen, Moshe |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32436684$$D View this record in MEDLINE/PubMed |
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| Copyright | COPYRIGHT 2020 Intellisphere, LLC Copyright Intellisphere, LLC May 2020 Copyright MultiMedia Healthcare Inc. 2020 |
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| Snippet | This study assessed rates of ambulatory care-sensitive condition (ACSC) admissions within a healthcare system to identify areas for intervention.
This was a... Objectives: This study assessed rates of ambulatory care–sensitive condition (ACSC) admissions within a healthcare system to identify areas for intervention.... Study Design: This was a multiyear cross-sectional study using the data warehouse of Clalit Health Services (Clalit), the largest payer/provider healthcare... This study assessed rates of ambulatory care-sensitive condition (ACSC) admissions within a healthcare system to identify areas for intervention.OBJECTIVESThis... |
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| SubjectTerms | 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 |
| Title | Analyzing admission rates for multiple ambulatory care–sensitive conditions |
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