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Comparison and Impact of Four Different Methodologies for Identification of Ambulatory Care Sensitive Conditions

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  • Andreia Pinto

    (Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
    CINTESIS–Center for Health Technology and Services Research, 4200-450 Porto, Portugal)

  • João Vasco Santos

    (Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
    CINTESIS–Center for Health Technology and Services Research, 4200-450 Porto, Portugal
    Public Health Unit, ACES Grande Porto VIII–Espinho/Gaia, 4500-330 Porto, Portugal)

  • Júlio Souza

    (Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
    CINTESIS–Center for Health Technology and Services Research, 4200-450 Porto, Portugal)

  • João Viana

    (Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
    CINTESIS–Center for Health Technology and Services Research, 4200-450 Porto, Portugal)

  • Cristina Costa Santos

    (Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
    CINTESIS–Center for Health Technology and Services Research, 4200-450 Porto, Portugal)

  • Mariana Lobo

    (Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
    CINTESIS–Center for Health Technology and Services Research, 4200-450 Porto, Portugal)

  • Alberto Freitas

    (Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal
    CINTESIS–Center for Health Technology and Services Research, 4200-450 Porto, Portugal)

Abstract

Ambulatory care sensitive conditions (ACSCs) are conditions for which hospitalizations are thought to be avoidable if effective and accessible primary health care is available. However, to define which conditions are considered ACSCs, there is a considerable number of different lists. Our aim was to compare the impact of using different ACSC lists considering mainland Portugal hospitalizations. A retrospective study with inpatient data from Portuguese public hospital discharges between 2011 and 2015 was conducted. Four ACSC list sources were considered: Agency for Healthcare Research and Quality (AHRQ), Canadian Institute for Health Information (CIHI), the Victorian Ambulatory Care Sensitive Conditions study, and Sarmento et al. Age–sex-adjusted rates of ACSCs were calculated by district (hospitalizations per 100,000 inhabitants). Spearman’s rho, the intraclass correlation coefficient (ICC), the information-based measure of disagreement (IBMD), and Bland and Altman plots were computed. Results showed that by applying the four lists, different age–sex-adjusted rates are obtained. However, the lists that seemed to demonstrate greater agreement and consistency were the list proposed by Sarmento et al. compared to AHRQ and the AHRQ method compared to the Victorian list. It is important to state that we should compare comparable indicators and ACSC lists cannot be used interchangeably.

Suggested Citation

  • Andreia Pinto & João Vasco Santos & Júlio Souza & João Viana & Cristina Costa Santos & Mariana Lobo & Alberto Freitas, 2020. "Comparison and Impact of Four Different Methodologies for Identification of Ambulatory Care Sensitive Conditions," IJERPH, MDPI, vol. 17(21), pages 1-14, November.
    • Handle: RePEc:gam:jijerp:v:17:y:2020:i:21:p:8121-:d:439493
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    References listed on IDEAS

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    1. William B. Weeks & Bruno Ventelou & Alain Paraponaris, 2016. "Rates of admission for ambulatory care sensitive conditions in France in 2009-2010: trends, geographic variation, costs, and an international comparison," Post-Print hal-01447863, HAL.
    2. Sundmacher, Leonie & Fischbach, Diana & Schuettig, Wiebke & Naumann, Christoph & Augustin, Uta & Faisst, Cristina, 2015. "Which hospitalisations are ambulatory care-sensitive, to what degree, and how could the rates be reduced? Results of a group consensus study in Germany," Health Policy, Elsevier, vol. 119(11), pages 1415-1423.
    3. João Victor Muniz Rocha & Carla Nunes & Rui Santana, 2019. "Avoidable hospitalizations in Brazil and Portugal: Identifying and comparing critical areas through spatial analysis," PLOS ONE, Public Library of Science, vol. 14(7), pages 1-16, July.
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    Cited by:

    1. Yu-Han Hung & Yu-Chieh Chung & Pi-Yueh Lee & Hao-Yun Kao, 2021. "Exploration of Preventable Hospitalizations for Colorectal Cancer with the National Cancer Control Program in Taiwan," IJERPH, MDPI, vol. 18(17), pages 1-9, September.
    2. João Sarmento & Margarida Siopa & Rodrigo Feteira-Santos & Sílvia Lopes & Sónia Dias & António Sousa Guerreiro & António Panarra & Paula Nascimento & Afonso Rodrigues & Ana Catarina Rodrigues & João V, 2022. "Patients’ Perspectives on Determinants Avoidable Hospitalizations: Development and Validation of a Questionnaire," IJERPH, MDPI, vol. 19(5), pages 1-14, March.

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