Abstract
Background
Ambulatory care sensitive conditions (ACSCs) are conditions for which the provision of timely and effective outpatient care can reduce the risks of hospitalisation by preventing, controlling or managing a chronic disease or condition.
Aims
The aims of this study were to report on ACSCs in Ireland, and to provide a baseline for future reference.
Methods
Using HIPE, via Health Atlas Ireland, inpatient discharges classified as ACSCs using definitions from the Victorian ACSC study were extracted for the years 2005–2008. Direct methods of standardisation allowed comparison of rates using the EU standard population as a comparison for national data, and national population as comparison for county data. Costs were estimated using diagnosis-related groups.
Results
The directly age-standardised discharge rate for ACSC-related discharges increased slightly, but non-significantly, from 15.40 per 1,000 population in 2005 to 15.75 per 1,000 population in 2008. The number of discharges increased (9.5%) from 63,619 in 2005 to 69,664 in 2008, with the estimated associated hospital costs increasing (31.5%) from €267.8 million in 2005 to €352.2 million in 2008. Across the country, there was considerable variation in the discharge rates for the Top-10 ACSCs for the years 2005–2008. Significantly lower rates of hospitalisation were observed in more urban areas including Cork, Dublin and Galway. The most common ACSC in 2008 was diabetes with complications (29.8%).
Conclusions
The variation in rates observed indicates the scope of reducing hospitalisations and associated costs for ACSCs, across both adult’s and children’s services and particularly in relation to diabetes complications.
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References
Billings J, Zeitel L, Lukomnik J, Carey TS, Blank AE, Newman L (1993) Impact of socioeconomic status on hospital use in New York City. Health Aff 12(1):162–173
Correa-Valez I, Ansari Z, Sundararajan V, Brown K, Gifford SM (2007) A six-year descriptive analysis of hospitalisations for ambulatory care sensitive conditions among people born in refugee-source countries. Population Health Metrics, 5:9 (BioMed Central)
Billings J (1996) Recent findings on preventable hospitalizations. Health Aff (Millwood) 15(3):239–249
Rizza P, Bianco A, Pavia M, Angelillo IF (2007) Preventable hospitalization and access to primary health care in an area of Southern Italy. BMC Health Serv Res 7:134 (BioMed Central)
Parker J, Schoendorf KC (2000) Variation in hospital discharges for ambulatory care-sensitive conditions among children. Pediatrics 106:942–948
Roos L, Walld R, Uhanova J, Bond R (2005) Physician visits, hospitalisations and socioeconomic status: ambulatory care sensitive conditions in a Canadian setting. doi:10.1111/j.1475-6773.2005.00407.x
Public Health, Rural and Regional Health and Aged Care Services Division (2004). The Victorian Ambulatory Care Sensitive Conditions Study Report 2001–2002. Victorian Government Department of Human Sciences, Melbourne
Purdy S, Griffin T, Salisbury C, Sharp D (2009) Ambulatory care sensitive conditions: terminology and disease coding need to be more specific to aid policy makers and clinicians. Public Health 123:169–173
Tabular List of Diseases (2004) Volume 1 of the international statistical classification of diseases & related health problems, tenth revision, Australian modification (ICD-10-AM). National Centre for Classification in Health, Australia
Census (2006) Central statistics office. Ireland. www.cso.ie
Population and Migration Estimates (2009) Central statistics office. Ireland. www.cso.ie
StatsDirect (2006) Version 2.5.5. UK
StatCalc, EPI-6 (2001) CDC USA & WHO, Geneva, Switzerland
Badrinath P, Flowers J (2009) Commissioning Brief No. 1 Ambulatory care sensitive conditions (ACSC) in the East of England. Eastern Region Public Health Observatory
Department of Human Services. ACSC 2004–2005 Update. Victoria State Government, Australia. www.health.vic.gov.au/healthstatus/admin/acsc/index.htm
Health Research and Information Division (2011) Activity in acute public hospitals in Ireland annual report 2010. The Economic and Social Research Institute, Dublin
Health Service Executive. (2010) Update on chronic disease programmes from the HSE quality and clinical care directorate. Naas, Co. Kildare, Ireland. www.hse.ie
Teljeur C, O’Dowd T, Thomas S, Kelly A (2010) The distribution of GPs in Ireland in relation to deprivation. Health and place. doi:10.1016/j.healthplace.2010.06.011
Acknowledgments
This report would not have been possible without the HIPE system provided by the Health Research and Information Division of the ESRI and the Web-based facilities of Health Atlas Ireland. We also acknowledge the assistance of Hannah Walford, Principal Analyst, Eastern Public Health Observatory (ERPHO), UK, for the study design.
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Sheridan, A., Howell, F. & Bedford, D. Hospitalisations and costs relating to ambulatory care sensitive conditions in Ireland. Ir J Med Sci 181, 527–533 (2012). https://doi.org/10.1007/s11845-012-0810-0
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DOI: https://doi.org/10.1007/s11845-012-0810-0