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Ambulatory sensitive admissions

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https://www.readbyqxmd.com/read/27837359/emergency-department-visits-and-hospitalizations-for-the-uninsured-in-illinois-before-and-after-affordable-care-act-insurance-expansion
#1
Aabha I Sharma, Scott M Dresden, Emilie S Powell, Raymond Kang, Joe Feinglass
We describe changes in emergency department (ED) visits and the proportion of patients with hospitalizations through the ED classified as Ambulatory Care Sensitive Hospitalization (ACSH) for the uninsured before (2011-2013) and after (2014-2015) Affordable Care Act (ACA) health insurance expansion in Illinois. Hospital administrative data from 201 non-federal Illinois hospitals for patients age 18-64 were used to analyze ED visits and hospitalizations through the ED. ACSH was defined using Agency for Healthcare Research and Quality (AHRQ) Prevention Quality Indicators (PQIs)...
November 12, 2016: Journal of Community Health
https://www.readbyqxmd.com/read/27827306/using-geographic-variation-in-unplanned-ambulatory-care-sensitive-condition-admission-rates-to-identify-commissioning-priorities-an-analysis-of-routine-data-from-england
#2
John Busby, Sarah Purdy, William Hollingworth
OBJECTIVES: To use geographic variation in unplanned ambulatory care sensitive condition admission rates to identify the clinical areas and patient subgroups where there is greatest potential to prevent admissions and improve the quality and efficiency of care. METHODS: We used English Hospital Episode Statistics data from 2011/2012 to describe the characteristics of patients admitted for ambulatory care sensitive condition care and estimated geographic variation in unplanned admission rates...
November 8, 2016: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/27777230/opportunities-for-primary-care-to-reduce-hospital-admissions-a-cross-sectional-study-of-geographical-variation
#3
John Busby, Sarah Purdy, William Hollingworth
BACKGROUND: Reducing unplanned hospital admissions is a key priority within the UK. Substantial interpractice variation in admission rates for ambulatory care sensitive conditions (ACSC) suggests that decreases might be possible. AIM: To identify the clinical areas and patient subgroups where the greatest opportunities exist for GPs to improve ACSC care. DESIGN AND SETTING: Cross-sectional study using routine hospital data from patients registered at 8123 English GP practices during 2011 and 2012...
October 24, 2016: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/27766628/physician-ehr-adoption-and-potentially-preventable-hospital-admissions-among-medicare-beneficiaries-panel%C3%A2-data-evidence-2010-2013
#4
Eric J Lammers, Catherine G McLaughlin, Michael Barna
OBJECTIVE: To test for correlation between the growth in adoption of ambulatory electronic health records (EHRs) in the United States during 2010-2013 and hospital admissions and readmissions for elderly Medicare beneficiaries with at least one of four common ambulatory care-sensitive conditions (ACSCs). DATA SOURCES: SK&A Information Services Survey of Physicians, American Hospital Association General Survey and Information Technology Supplement; and the Centers for Medicare & Medicaid Services Chronic Conditions Data Warehouse Geographic Variation Database for 2010 through 2013...
October 21, 2016: Health Services Research
https://www.readbyqxmd.com/read/27745857/evaluating-the-impact-of-an-enhanced-primary-care-diabetes-service-on-diabetes-outcomes-a-before-after-study
#5
S Seidu, D H Bodicoat, M J Davies, H Daly, B Stribling, A Farooqi, E M Brady, K Khunti
: Diabetes is an ambulatory care-sensitive condition and a high quality primary care or risk factor control can lead to a decrease in the risk of non-elective hospitalisations while ensuring continuity of care with usual primary care teams. AIMS AND METHODS: In this before and after study, eight primary care practices providing a newer enhanced diabetes model of care in Leicester UK, were compared with matched neighbouring practices with comparable demographic features providing a more expensive integrated specialist-community care diabetes service...
October 10, 2016: Primary Care Diabetes
https://www.readbyqxmd.com/read/27716250/the-impact-of-reimbursement-systems-on-equity-in-access-and-quality-of-primary-care-a-systematic-literature-review
#6
Wenjing Tao, Janne Agerholm, Bo Burström
BACKGROUND: Reimbursement systems provide incentives to health care providers and may drive physician behaviour. This review assesses the impact of reimbursement system on socioeconomic and racial inequalities in access, utilization and quality of primary care. METHODS: A systematic search was performed in Web of Science and PubMed for English language studies published between 1980 and 2013, supplemented by reference tracking. Articles were selected based on inclusion criteria, and data extraction and critical appraisal were performed by two authors independently...
October 4, 2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27650770/comparison-of-count-based-multimorbidity-measures-in-predicting-emergency-admission-and-functional-decline-in-older-community-dwelling-adults-a-prospective-cohort-study
#7
Emma Wallace, Ronald McDowell, Kathleen Bennett, Tom Fahey, Susan M Smith
OBJECTIVES: Multimorbidity, defined as the presence of 2 or more chronic medical conditions in an individual, is associated with poorer health outcomes. Several multimorbidity measures exist, and the challenge is to decide which to use preferentially in predicting health outcomes. The study objective was to compare the performance of 5 count-based multimorbidity measures in predicting emergency hospital admission and functional decline in older community-dwelling adults attending primary care...
2016: BMJ Open
https://www.readbyqxmd.com/read/27648258/shifting-chronic-disease-management-from-hospitals-to-primary-care-in-estonian-health-system-analysis-of-national-panel-data
#8
Rifat Atun, Ipek Gurol-Urganci, Thomas Hone, Lisa Pell, Jonathan Stokes, Triin Habicht, Kaija Lukka, Elin Raaper, Jarno Habicht
BACKGROUND: Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. METHODS: Using routinely collected health billing records for 2005-2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co-morbidities)...
December 2016: Journal of Global Health
https://www.readbyqxmd.com/read/27622354/intestinal-ultrasonography-in-the-diagnosis-and-management-of-colonic-diverticular-disease
#9
Giovanni Maconi, Stefania Carmagnola, Tom Guzowski
Diverticula of the colon and their symptomatic manifestations, including acute diverticulitis (AD), are frequent complaints and the cause of an increasing burden of ambulatory visits, diagnostic procedures, and hospital admissions. Endoscopic and radiologic diagnostic procedures have a well-known role in the diagnosis and management of the disease, but recently intestinal ultrasonography has been proposed as a complementary tool in the diagnosis and follow-up of diverticular disease. This review shows the main sonographic features of diverticula and discusses the potential role of ultrasound in suggesting the presence of symptomatic uncomplicated diverticular disease of the colon...
October 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27612980/increase-in-avoidable-hospital-admissions-after-the-great-east-japan-earthquake
#10
Yusuke Sasabuchi, Hiroki Matsui, Hideo Yasunaga, Kiyohide Fushimi
BACKGROUND: The Great East Japan Earthquake and subsequent tsunami and nuclear disaster on 11 March 2011 had a short-term influence on the increase in emergency department visits and hospital admissions due to various diseases. However, it remains unclear whether the earthquake and tsunami disaster affected the long-term health conditions of people in the affected areas. METHODS: Using a national inpatient database in Japan, we investigated people's ambulatory care sensitive conditions (ACSCs), which are defined as conditions for which effective management and treatment should prevent admission to a hospital...
September 9, 2016: Journal of Epidemiology and Community Health
https://www.readbyqxmd.com/read/27593604/per-capita-medicare-expenditures-primary-care-access-mortality-rates-and-the-least-healthy-cities-in-america
#11
William B Weeks, James N Weinstein
PURPOSE: To determine whether several measures of health care expenditures, access, and outcomes for the 25 recently identified "least healthy cities in America" differed from those in the rest of America. METHODS: For 2004 and 2013, we obtained publicly available price-, age-, sex-, and race-adjusted hospital service area per-capita Medicare expenditures; age-, sex-, and race-adjusted Medicare mortality rates; and 2 indicators of primary care access: the proportion of enrollees having at least one ambulatory visit to a primary care clinician and the per-capita discharge rate for ambulatory care sensitive conditions...
September 2, 2016: American Journal of Medicine
https://www.readbyqxmd.com/read/27579911/perceived-stress-multimorbidity-and-risk-for-hospitalizations-for-ambulatory-care-sensitive-conditions-a-population-based-cohort-study
#12
Anders Prior, Mogens Vestergaard, Dimitry S Davydow, Karen K Larsen, Anette R Ribe, Morten Fenger-Grøn
BACKGROUND: Psychiatric disorders are associated with an increased risk for ambulatory care-sensitive condition (ACSC)-related hospitalizations, but it remains unknown whether this holds for individuals with nonsyndromic stress that is more prevalent in the general population. OBJECTIVES: To determine whether perceived stress is associated with ACSC-related hospitalizations and rehospitalizations, and posthospitalization 30-day mortality. RESEARCH DESIGN AND MEASURES: Population-based cohort study with 118,410 participants from the Danish National Health Survey 2010, which included data on Cohen's Perceived Stress Scale, followed from 2010 to 2014, combined with individual-level national register data on hospitalizations and mortality...
August 30, 2016: Medical Care
https://www.readbyqxmd.com/read/27572143/economic-burden-of-mental-illnesses-in-pakistan
#13
Muhammad Ashar Malik, Murad Moosa Khan
BACKGROUND: The economic consequences of mental illnesses are much more than health consequences. In Low and Middle Income Countries (LMIC) the economic impact of mental illnesses is rarely analyzed. This paper attempts to fill the gap in research on economics of mental health in LMIC. We provide economic burden of mental illness in Pakistan that can serve as an argument for reorienting health policy, resource allocation and priority settings. AIM: To estimate economic burden of mental illnesses in Pakistan...
September 2016: Journal of Mental Health Policy and Economics
https://www.readbyqxmd.com/read/27552616/association-of-integrated-team-based-care-with-health-care-quality-utilization-and-cost
#14
COMPARATIVE STUDY
Brenda Reiss-Brennan, Kimberly D Brunisholz, Carter Dredge, Pascal Briot, Kyle Grazier, Adam Wilcox, Lucy Savitz, Brent James
IMPORTANCE: The value of integrated team delivery models is not firmly established. OBJECTIVE: To evaluate the association of receiving primary care in integrated team-based care (TBC) practices vs traditional practice management (TPM) practices (usual care) with patient outcomes, health care utilization, and costs. DESIGN: A retrospective, longitudinal, cohort study to assess the association of integrating physical and mental health over time in TBC practices with patient outcomes and costs...
August 23, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27547944/disease-specific-pay-for-performance-programs-do-the-p4p-effects-differ-between-diabetic-patients-with-and-without-multiple-chronic-conditions
#15
Yu-Chin Huang, Miaw-Chwen Lee, Yiing-Jenq Chou, Nicole Huang
BACKGROUND: Several studies have investigated the effects of pay-for-performance (P4P) initiatives. However, little is known about whether patients with multiple chronic conditions (MCC) would benefit from P4P initiatives similarly to patients without MCC. OBJECTIVES: The objective of this study was to compare the effects of the diabetes mellitus pay-for-performance (DM-P4P) program on the quality of diabetic care between type 2 diabetic patients with and without MCC...
November 2016: Medical Care
https://www.readbyqxmd.com/read/27524786/effect-of-the-economic-recession-on-primary-care-access-for-the-homeless
#16
Brandi M White, Walter J Jones, William P Moran, Kit N Simpson
Primary care access (PCA) for the homeless can prove challenging, especially during periods of economic distress. In the United States, the most recent recession may have presented additional barriers to accessing care. Limited safety-net resources traditionally used by the homeless may have also been used by the non-homeless, resulting in delays in seeking treatment for the homeless. Using hospitalizations for ambulatory care sensitivity (ACS) conditions as a proxy measure for PCA, this study investigated the recession's impact on PCA for the homeless and non-homeless in four states...
2016: Journal of Health Care for the Poor and Underserved
https://www.readbyqxmd.com/read/27488262/the-impact-of-multiple-chronic-diseases-on-hospitalizations-for-ambulatory-care-sensitive-conditions
#17
Inês Dantas, Rui Santana, João Sarmento, Pedro Aguiar
BACKGROUND: The high financial burden of avoidable hospitalizations has led to an increase of the study of hospitalizations for ambulatory care sensitive conditions (ACSC). There is limited information on the impact of secondary diagnoses on these hospitalizations, although patients' social and demographic characteristics, as well as the coexistence of multiple diseases are often identified in the literature as risk factors for avoidable hospitalizations. This study explores the impact of chronic conditions on the likelihood of hospitalizations for ACSC...
2016: BMC Health Services Research
https://www.readbyqxmd.com/read/27486003/differential-access-to-care-the-role-of-age-insurance-and-income-on-race-ethnicity-related-disparities-in-adult-perforated-appendix-admission-rates
#18
Cheryl K Zogg, John W Scott, Wei Jiang, Lindsey L Wolf, Adil H Haider
BACKGROUND: Differences in perforated appendix admission rates (PAAR) are an ambulatory-sensitive measure of access to care. While pediatric studies report disparities in PAAR, initial adult investigations suggest a lack of racial/ethnic inequity. The objectives of this study were to (1) assess for risk-adjusted, racial/ethnic differences in PAAR among adults on a national scale, (2) consider the extent to which variations (or lack thereof) are explained by age, insurance, and income, and (3) compare results within the United States population to a national segment of the population who are completely insured...
July 30, 2016: Surgery
https://www.readbyqxmd.com/read/27434444/cellulitis-a-review
#19
REVIEW
Adam B Raff, Daniela Kroshinsky
IMPORTANCE: Cellulitis is an infection of the deep dermis and subcutaneous tissue, presenting with expanding erythema, warmth, tenderness, and swelling. Cellulitis is a common global health burden, with more than 650,000 admissions per year in the United States alone. OBSERVATIONS: In the United States, an estimated 14.5 million cases annually of cellulitis account for $3.7 billion in ambulatory care costs alone. The majority of cases of cellulitis are nonculturable and therefore the causative bacteria are unknown...
July 19, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27398370/emergency-department-use-by-people-with-hiv-in-ontario-a-population-based-cohort-study
#20
Ryan Ng, Claire E Kendall, Ann N Burchell, Ahmed M Bayoumi, Mona R Loutfy, Janet Raboud, Richard H Glazier, Sean Rourke, Tony Antoniou
BACKGROUND: Emergency department use may reflect poor access to primary care. Our objective was to compare rates and causes of emergency department use between adults living with and without HIV. METHODS: We conducted a population-based study involving Ontario residents living with and without HIV between Apr. 1, 2011, and Mar. 31, 2012. We frequency matched adults with HIV to 4 HIV-negative people by age, sex and census division, and used random-effects negative binomial regression to compare rates of emergency department use...
April 2016: CMAJ Open
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