Admissions for chronic ambulatory care sensitive conditions - a useful measure of potentially preventable admission?
Admissions for chronic ambulatory care sensitive conditions - a useful measure of potentially preventable admission?
复制标题
DOI：
10.1186/s12913-015-1137-0
复制
发表时间：
2015-10-16
影响因子：
2.8
通讯作者：
Morgan, Geoffrey G.
中科院分区：
文献类型：
--
作者：
Longman, Jo M.;Passey, Megan E.;Morgan, Geoffrey G.
背景：近三十年来，潜在可预防的住院（在社区医疗保健环境中给予适当护理被认为是潜在可预防的入院）一直是国际研究关注的话题。最近，这主要是由于必须减少不断增加的计划外住院人数。然而，识别潜在的、可预防的入院是很困难的。因此，门诊护理敏感病症 (ACSC) 入院的人口水平指标已被用作潜在可预防入院的替代指标。这一措施的采用已经变得很普遍，在澳大利亚，慢性 ACSC 的入院率现在是衡量卫生系统绩效和问责制的重要组成部分，并且与资金直接相关。慢性 ACSC 的入院还用于识别个体，以采取干预措施来减少可预防的入院讨论：慢性 ACSC 的入院是基于入院诊断的人口衡量标准，因此不应用于识别个人可预防的入院。目前，我们无法确定哪些入院是可预防的，或者因此无法阐明与可预防的入院相关的因素。总结：由于我们目前无法确定哪些入院是可预防的，因此我们对导致可预防入院的根本原因和因素知之甚少。需要一种评估个人入院可预防性的方法。只有这样，我们才能探索前因，以及患者和临床医生对可预防入院的看法。在我们对此有更清晰的了解之前，我们为政策和计划制定提供信息的能力仍然受到损害。
Background: Potentially preventable hospital admission (an admission deemed to be potentially preventable given appropriate care in the community-based healthcare setting) has been a topic of international research attention for almost three decades. Recently this has been largely driven by the imperative to reduce ever-increasing unplanned hospital admissions. However, identifying potentially preventable admissions is difficult. As a result, the population level indicator of admissions for ambulatory care sensitive conditions (ACSCs) has been used as a proxy measure for potentially preventable admission. The adoption of this measure has become common, and in Australia, the rate of admissions for chronic ACSCs is now an important component of measuring health system performance and accountability, and is directly linked to funding. Admission for a chronic ACSC is also used to identify individuals for targeting of interventions to reduce preventable admissionDiscussion: Hospital admission for chronic ACSCs is a population measure based on admission diagnoses, it therefore should not be used to identify individual preventable admissions. At present we are unable to determine individual admissions that are deemed to be preventable or, therefore, articulate the factors associated with admissions which are preventable.Summary: As we are currently unable to identify individual admissions that are preventable, little is understood about the underlying causes and factors contributing to preventable admissions. A means of assessing preventability of individual admissions is required. Only then can we explore the antecedents, and patient and clinician perspectives on preventable admissions. Until we have a clearer understanding of this, our capacity to inform policy and program development remains compromised.