Publicatie
Publication date
Evolution of the concept of avoidable hospitalization through the selections of causes and codes: evidence from a comprehensive review.
Pelone, F., Basso, D., Lilli, S., Belvis, A.G. de, Rosano, A., Zee, J. van der, Ricciardi, W. Evolution of the concept of avoidable hospitalization through the selections of causes and codes: evidence from a comprehensive review. European Journal of Public Health: 2010, 20(suppl. 1), p. 78. Abstract. 3rd European Public Health Conference 'Integrated Public Health', 10 - 13 November 2010, Amsterdam.
Background: Ambulatory care sensitive conditions (ACSCs) are diseases where the provision of primary health care (PHC) interventions may affect the severity of the disease and prevent hospitalization. This study aimed at exploring changes of different definitions and classification of ACSCs and the relationship with models of health care system in Established Market Economy countries, according to World Bank definition. Methods: A key-word search on the medical literature published till 2010, was carried out on MEDLINE; SCOPUS and Chinail. In addition grey literature was explored. Included studies were primary epidemiological searches that referred to analyse the relationship between ACSC, PHC and health care model classified as National Health Service (NHS) type, Social Insurance (SI) type and Private Health Insurance (PHI) type. Results: The primary search yielded 264 citations; after the selection process, 114 papers underwent detailed review. A total of 23 papers were eligible for inclusion. Most of the selected paper came from USA (10 studies), followed by European Countries (six studies), Canada (three studies), Australia/New Zealand (two studies) and other EME countries (two studies). By analysing health systems type, most of studies were targeted PHI model (39%), six studies (26%) were focalized on SI type of system, while eight studies were centered on NHS systems. The majority of studies have been carried on since 2002: from 2002 to 2006 (14 studies) and from 2006 to 2010 (three studies); before 2002 a small number of papers have been published (six studies). Conclusions: Findings of our ongoing research show that both in different health care delivery systems and overtime, the choice of different definitions and diagnostic codes for identifying ACSCs impact significantly on the proportion of hospitalization attributable to ACSCs. To properly identify ACSCs will be useful to health services researchers and health policy makers; doing so strengthened targeted policy interventions to efficiently improve access to primary care.
Background: Ambulatory care sensitive conditions (ACSCs) are diseases where the provision of primary health care (PHC) interventions may affect the severity of the disease and prevent hospitalization. This study aimed at exploring changes of different definitions and classification of ACSCs and the relationship with models of health care system in Established Market Economy countries, according to World Bank definition. Methods: A key-word search on the medical literature published till 2010, was carried out on MEDLINE; SCOPUS and Chinail. In addition grey literature was explored. Included studies were primary epidemiological searches that referred to analyse the relationship between ACSC, PHC and health care model classified as National Health Service (NHS) type, Social Insurance (SI) type and Private Health Insurance (PHI) type. Results: The primary search yielded 264 citations; after the selection process, 114 papers underwent detailed review. A total of 23 papers were eligible for inclusion. Most of the selected paper came from USA (10 studies), followed by European Countries (six studies), Canada (three studies), Australia/New Zealand (two studies) and other EME countries (two studies). By analysing health systems type, most of studies were targeted PHI model (39%), six studies (26%) were focalized on SI type of system, while eight studies were centered on NHS systems. The majority of studies have been carried on since 2002: from 2002 to 2006 (14 studies) and from 2006 to 2010 (three studies); before 2002 a small number of papers have been published (six studies). Conclusions: Findings of our ongoing research show that both in different health care delivery systems and overtime, the choice of different definitions and diagnostic codes for identifying ACSCs impact significantly on the proportion of hospitalization attributable to ACSCs. To properly identify ACSCs will be useful to health services researchers and health policy makers; doing so strengthened targeted policy interventions to efficiently improve access to primary care.