National Norms for Hospitalizations Due to Ambulatory Care Sensitive Conditions among Adults in the US

Abstract

Background Ambulatory care sensitive conditions (ACSCs) are acute or chronic health issues that lead to potentially preventable hospitalizations when not treated in the outpatient primary care setting. Objective To describe national hospitalization rates due to ACSCs among adult inpatients in the US. Design A retrospective cross-sectional analysis of the 2018 US National Inpatient Sample (NIS) dataset from the Healthcare Cost and Utilization Project at the Agency of Healthcare Research and Quality was completed in the year 2022. Participants Participants were adult inpatients from community hospitals in 48 states of the US and District of Columbia. Main Measures ACSC admission rates were calculated using ICD-10 codes and the Purdy ACSC definition. The admission rates were weighted to the US inpatient population and stratified by age, sex, and race. Key Results ACSC hospitalization rates varied considerably across age and average number of hospitalizations varied across sex and race. ACSC hospitalization rates increased with age, male sex, and Native American and Black race. The most common ACSCs were pneumonia, diabetes, and congestive heart failure. Conclusions Previous studies have emphasized the importance of preventable hospitalizations, however, the national rates for ACSC hospitalizations across all ages in the US have not been reported. The national rates presented will facilitate comparisons to identify hospitals and health care systems with higher-than-expected rates of ACSC admissions that may suggest a need for improved primary care services.

Preventable hospitalization in chronic degenerative diseases: arterial hypertension and diabetes

“…Varias investigaciones discuten cual es la causa principal sobre las tasas de hospitalización, en las cuales mencionan como causa principal el nivel de educación e ingresos económicos, entre otras mencionan que la detección de una enfermedad en estadío temprano podría ser posible por la accesibilidad médica gratuita. (27) Dentro de las medidas preventivas de hospitalizaciones por Hipertensión Arterial se centran en cambios estructurales del paciente y su cuidador ya que se debe tener presente que si no es controlada una crisis hipertensiva se triplica la mortalidad del paciente por riesgo de ACV, por lo cual es importante clasificar la crisis como urgencia o emergencia hipertensiva, para lo cual la prevención de estas crisis deben ser multifactorial y dirigida a cubrir todos los requerimientos del paciente para evitar el daño de algún órgano diana. (16,28) Por otra parte, es importante mencionar la participación de enfermería en la Atención Primaria de Salud principalmente en Hipertensión Arterial y Diabetes Mellitus, ya que puede cambiar el escenario epidemiológico en donde predominan las enfermedades crónico degenerativas, ya que es importante satisfacer la demanda de prestación de servicios, centrados en la captación temprana, seguimiento y fortalecimiento de estrategias que brinden continuidad en el tratamiento empleado sobre el paciente, (20) sin embargo, la atención de pacientes crónicos es desproporcional ya que se debe complementar la atención, mediante atención con nutricionista, médico general, enfermería y odontología, en conjunto con el autocuidado.…”

A case vignette study to refine the target group of an intermediate care model: the Acute Geriatric Community Hospital

“…Acute geriatric units (AGUs) provide acute medical care services for older adults with Ambulatory Care Sensitive Conditions [21], such as heart failure, pneumonia, COPD, and frailty. When chronic conditions worsen or 'minor' acute events occur, patients receive acute care and early rehabilitation at the AGU instead of in the hospital [22].…”