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Ambulatory sensitive admissions

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https://www.readbyqxmd.com/read/29772472/postintroduction-study-of-cost-effectiveness-of-pneumococcal-vaccine-pcv10-from-public-sector-payer-s-perspective-in-the-state-of-santa-catarina-brazil
#1
Emil Kupek, Ilse Viertel
OBJECTIVES: To evaluate cost effectiveness of 10-valent pneumococcal conjugate vaccine in the routine immunization program for children younger than 5 years in Brazil by a postintroduction study. METHODS: Ecological study of prevaccine (2006-2009) versus postvaccine (2011-2014) period related the changes in mortality rate and hospitalization rate to direct cost of pneumonia treatment from the payer's perspective to estimate the cost effectiveness regarding lives saved, life-years gained, and disability-adjusted life-year for children younger than 5 years in the southern Brazilian state of Santa Catarina...
May 14, 2018: Value in Health Regional Issues
https://www.readbyqxmd.com/read/29770534/evaluating-the-impact-of-physicians-provision-on-primary-healthcare-evidence-from-brazil-s-more-doctors-program
#2
Luiz Felipe Campos Fontes, Otavio Canozzi Conceição, Paulo de Andrade Jacinto
This study aims to evaluate the More Doctors Program (Programa Mais Médicos) in terms of the provision of physicians, presenting estimates of its impact on hospitalization for ambulatory care sensitive conditions. The differences-in-differences method was used with propensity score matching (double difference matching), using 3 specifications, a falsification test, and also a dynamic endogeneity test to confirm the robustness of the results. For the application of this methodology, a panel of municipal data was constructed covering several variables related to socioeconomic, demographic, and public health infrastructure characteristics in the cities for the period from 2010 to 2016...
May 16, 2018: Health Economics
https://www.readbyqxmd.com/read/29705762/does-practice-analysis-agree-with-the-ambulatory-care-sensitive-conditions-list-of-avoidable-unplanned-admissions-a-cross-sectional-study-in-the-east-of-england
#3
Robert Fleetcroft, Antonia Hardcastle, Nicholas Steel, Gill M Price, Sarah Purdy, Alistair Lipp, Phyo Kyaw Myint, Amanda Howe
OBJECTIVES: To use significant event audits (SEAs) in primary care to determine which of a sample of emergency (unplanned) admissions were potentially avoidable; and compare with the National Health Service (NHS) list of ambulatory care sensitive conditions (ACSCs). DESIGN: Analysis of unplanned medical admissions randomly identified in secondary care. SETTING: Primary care in the East of England. PARTICIPANTS: 20 general practice teams trained to use SEA on unplanned admissions to identify potentially preventable factors...
April 28, 2018: BMJ Open
https://www.readbyqxmd.com/read/29650019/the-effect-of-north-carolina-free-clinics-on-hospitalizations-for-ambulatory-care-sensitive-conditions-among-the-uninsured
#4
Jenny Hutchison, Michael E Thompson, Jennifer Troyer, Christine Elnitsky, Maren J Coffman, M Lori Thomas
BACKGROUND: Free clinics are volunteer based organizations that provide health care services to low-income individuals for free or minimal cost. Communities served by a free clinic can provide ambulatory care services for uninsured individuals, reducing reliance on costly hospital admissions for ambulatory care sensitive conditions. This study examines whether free clinics in North Carolina reduce hospitalizations for ambulatory care sensitive conditions for uninsured adults. METHODS: The study used North Carolina hospital discharge data from 2003 to 2007, restricted to uninsured adults residing in North Carolina (N = 270,325)...
April 12, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29533272/team-functioning-as-a-predictor-of-patient-outcomes-in-early-medical-home-implementation
#5
Frances M Wu, Lisa V Rubenstein, Jean Yoon
BACKGROUND: New models of patient-centered primary care such as the patient-centered medical home (PCMH) depend on high levels of interdisciplinary primary care team functioning to achieve improved outcomes. A few studies have qualitatively assessed barriers and facilitators to optimal team functioning; however, we know of no prior study that assesses PCMH team functioning in relationship to patient health outcomes. PURPOSE: The aim of the study was to assess the relationships between primary care team functioning, patients' use of acute care, and mortality...
March 12, 2018: Health Care Management Review
https://www.readbyqxmd.com/read/29478966/use-of-health-services-in-the-last-year-of-life-and-cause-of-death-in-people-with-intellectual-disability-a-retrospective-matched-cohort-study
#6
Kate Brameld, Katrina Spilsbury, Lorna Rosenwax, Helen Leonard, James Semmens
OBJECTIVE: To describe the cause of death together with emergency department presentations and hospital admissions in the last year of life of people with intellectual disability. METHOD: A retrospective matched cohort study using de-identified linked data of people aged 20 years or over, with and without intellectual disability who died during 2009 to 2013 in Western Australia. Emergency department presentations and hospital admissions in the last year of life of people with intellectual disability are described along with cause of death...
February 25, 2018: BMJ Open
https://www.readbyqxmd.com/read/29453197/paediatric-hospital-admission-processes-and-outcomes-a-qualitative-study-of-parents-experiences-and-priorities
#7
JoAnna K Leyenaar, Paul A Rizzo, Emily R O'Brien, Peter K Lindenauer
BACKGROUND: Hospital admission, like hospital discharge, represents a transition of care associated with changes in setting, healthcare providers and clinical management. While considerable efforts have focused on improving the quality and safety of hospital-to-home transitions, there has been little focus on transitions into hospital. OBJECTIVES: Among children hospitalised with ambulatory care sensitive conditions, we aimed to characterise families' experiences as they transitioned from outpatient to inpatient care, identify hospital admission processes and outcomes most important to families and determine how parental perspectives differed between children admitted directly and through emergency departments (ED)...
February 16, 2018: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29335161/health-equity-monitoring-for-healthcare-quality-assurance
#8
R Cookson, M Asaria, S Ali, R Shaw, T Doran, P Goldblatt
Population-wide health equity monitoring remains isolated from mainstream healthcare quality assurance. As a result, healthcare organizations remain ill-informed about the health equity impacts of their decisions - despite becoming increasingly well-informed about quality of care for the average patient. We present a new and improved analytical approach to integrating health equity into mainstream healthcare quality assurance, illustrate how this approach has been applied in the English National Health Service, and discuss how it could be applied in other countries...
February 2018: Social Science & Medicine
https://www.readbyqxmd.com/read/29320892/the-effect-of-the-global-financial-crisis-on-preventable-hospitalizations-among-the-homeless-in-new-york-state
#9
Brandi White, Charles Ellis, Walter Jones, William Moran, Kit Simpson
Objective Periods of economic instability may increase preventable hospitalizations because of increased barriers to accessing primary care. For underserved populations such as the homeless, these barriers may be more pronounced due to limited resources in the health care safety net. This study examined the impact of the global financial crisis of 2007-2008 on access to care for the homeless in New York State. Methods Hospitalizations for ambulatory care sensitive conditions (ACSCs) were used as a proxy measure for primary care access...
January 1, 2018: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/29305379/short-stay-admissions-at-an-inner-city-hospital-a-cross-sectional-analysis
#10
Ian Pope, Sharif Ismail, Benjamin Bloom, Gwyneth Jansen, Helen Burn, David McCoy, Tim Harris
OBJECTIVE: To investigate factors predictive of short hospital admissions and appropriate placement to inpatient versus clinical decision units (CDUs). METHOD: This is a retrospective analysis of attendance and discharge data from an inner-city ED in England for December 2013. The primary outcome was admission for less than 48 hours either to an inpatient unit or CDU. Variables included: age, gender, ethnicity, deprivation score, arrival date and time, arrival method, admission outcome and discharge diagnosis...
April 2018: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29282266/senior-high-cost-healthcare-users-resource-utilization-and-outcomes-a-protocol-of-a-retrospective-matched-cohort-study-in-canada
#11
Sergei Muratov, Justin Lee, Anne Holbrook, J Michael Paterson, Jason Robert Guertin, Lawrence Mbuagbaw, Tara Gomes, Wayne Khuu, Priscila Pequeno, Andrew P Costa, Jean-Eric Tarride
INTRODUCTION: Senior high-cost users (HCUs) are estimated to represent 60% of all HCUs in Ontario, Canada's most populous province. To improve our understanding of individual and health system characteristics related to senior HCUs, we will examine incident senior HCUs to determine their incremental healthcare utilisation and costs, characteristics of index hospitalisation episodes, mortality and their regional variation across Ontario. METHODS AND ANALYSIS: A retrospective, population-based cohort study using administrative healthcare records will be used...
December 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/29225926/does-expanding-primary-healthcare-improve-hospital-efficiency-evidence-from-a-panel-analysis-of-avoidable-hospitalisations-in-5506-municipalities-in-brazil-2000-2014
#12
Everton Nunes da Silva, Timothy Powell-Jackson
Background: Hospitals account for the major share of health expenditure. Primary healthcare may improve efficiency at the hospital level by reducing avoidable admissions. We examined whether rapid expansion of primary healthcare in the context of Brazil's Family Health Strategy (FHS) was associated with a reduction in avoidable hospitalisations. Methods: We constructed panel data for 5506 municipalities over 2000-2014. Our primary outcome was the rate of avoidable hospitalisations, defined with reference to the official list of ambulatory care sensitive conditions (ACSC)...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29198530/hospitalizations-for-ambulatory-care-sensitive-conditions-among-children-with-chronic-and-complex-diseases
#13
Ryan J Coller, Michelle M Kelly, Mary L Ehlenbach, Evan Goyette, Gemma Warner, Paul J Chung
OBJECTIVE: To evaluate ambulatory-care sensitive (ACS) hospitalizations for children with noncomplex chronic diseases (NC-CD) and children with medical complexity (CMC), and identify associations with ambulatory care characteristics. Although ACS hospitalizations are potentially preventable in general populations, the specific ambulatory care predictors and influence of medical complexity on them is poorly understood. STUDY DESIGN: Retrospective cohort study of NC-CD and CMC hospitalizations at a children's hospital during 2007-2014, excluding labor/delivery and children over 21 years...
March 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29141614/differences-in-the-prevalence-of-hospitalizations-and-utilization-of-emergency-outpatient-services-for-ambulatory-care-sensitive-conditions-between-asylum-seeking-children-and-children-of-the-general-population-a-cross-sectional-medical-records-study-2015
#14
Célina Lichtl, Thomas Lutz, Joachim Szecsenyi, Kayvan Bozorgmehr
BACKGROUND: Hospitalizations for ambulatory care sensitive (ACS) conditions are established indicators for the availability and quality of ambulatory care. We aimed to assess the differences between asylum-seeking children and children of the general population in a German city with respect to (i) the prevalence of ACS hospitalizations, and (ii) the utilization of emergency outpatient services for ACS conditions. METHODS: Using anonymous account data, all children admitted to the University Hospital Heidelberg in 2015 were included in our study...
November 15, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29118053/international-variations-in-primary-care-physician-consultation-time-a-systematic-review-of-67-countries
#15
Greg Irving, Ana Luisa Neves, Hajira Dambha-Miller, Ai Oishi, Hiroko Tagashira, Anistasiya Verho, John Holden
OBJECTIVE: To describe the average primary care physician consultation length in economically developed and low-income/middle-income countries, and to examine the relationship between consultation length and organisational-level economic, and health outcomes. DESIGN AND OUTCOME MEASURES: This is a systematic review of published and grey literature in English, Chinese, Japanese, Spanish, Portuguese and Russian languages from 1946 to 2016, for articles reporting on primary care physician consultation lengths...
November 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/29082562/rate-and-characteristics-of-urgent-hospitalisation-in-persons-with-profound-intellectual-disabilities-compared-with-general-population
#16
A Amor-Salamanca, J M Menchon
BACKGROUND: Little is known about the hospitalisation rate of adults with severe/profound intellectual disability (PID) presenting at emergency services or about the appropriateness of hospital admissions in this population. Examining the possible differences in the patterns of hospitalisation between people with PID and those without intellectual disability (ID) may shed light on aspects of health and illness in these patients and may in turn make it possible to differentiate more clearly between mild-moderate ID and PID...
March 2018: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/29049488/concentration-of-potentially-preventable-spending-among-high-cost-medicare-subpopulations-an-observational-study
#17
Jose F Figueroa, Karen E Joynt Maddox, Nancy Beaulieu, Robert C Wild, Ashish K Jha
Background: Little is known about whether potentially preventable spending is concentrated among a subset of high-cost Medicare beneficiaries. Objective: To determine the proportion of total spending that is potentially preventable across distinct subpopulations of high-cost Medicare beneficiaries. Design: Beneficiaries in the highest 10% of total standardized individual spending were defined as "high-cost" patients, using a 20% sample of Medicare fee-for-service claims from 2012...
November 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28986347/relation-between-family-physician-retention-and-avoidable-hospital-admission-in-newfoundland-and-labrador-a-population-based-cross-sectional-study
#18
John C Knight, Maria Mathews, Kris Aubrey-Bassler
BACKGROUND: Physician turnover, involving physicians' leaving clinical practice in a specific area, may disrupt continuity of care, leading to poorer health outcomes and greater use of health care services. The purpose of this study was to investigate the relation between family physician retention and avoidable hospital admission for ambulatory-care-sensitive conditions. METHODS: We conducted a population-based cross-sectional study using provincial health administrative data for residents of Newfoundland and Labrador who held a provincial health card between 2001 and 2009...
October 6, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28893817/preventable-emergency-hospital-admissions-among-adults-with-intellectual-disability-in-england
#19
Fay J Hosking, Iain M Carey, Stephen DeWilde, Tess Harris, Carole Beighton, Derek G Cook
PURPOSE: Adults with intellectual disabilities experience poorer physical health and health care quality, but there is limited information on the potential for reducing emergency hospital admissions in this population. We describe overall and preventable emergency admissions for adults with vs without intellectual disabilities in England and assess differences in primary care management before admission for 2 common ambulatory care-sensitive conditions (ACSCs). METHODS: We used electronic records to study a cohort of 16,666 adults with intellectual disabilities and 113,562 age-, sex-, and practice-matched adults without intellectual disabilities from 343 English family practices...
September 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28827243/do-hospitalisations-for-ambulatory-care-sensitive-conditions-reflect-low-access-to-primary-care-an-observational-cohort-study-of-primary-care-usage-prior-to-hospitalisation
#20
Sabine I Vuik, Gianluca Fontana, Erik Mayer, Ara Darzi
OBJECTIVES: To explore whether hospitalisations for ambulatory care sensitive conditions (ACSCs) are associated with low access to primary care. DESIGN: Observational cohort study over 2008 to 2012 using the Clinical Practice Research Datalink (CPRD) and Hospital Episode Statistics (HES) databases. SETTING: English primary and secondary care. PARTICIPANTS: A random sample of 300 000 patients. MAIN OUTCOME MEASURES: Emergency hospitalisation for an ACSC...
August 21, 2017: BMJ Open
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