Preventable hospitalization and access to primary health care in an area of Southern Italy

Rizza, Paolo; Bianco, Aida; Pavia, Maria; Angelillo, Italo Francesco

doi:10.1186/1472-6963-7-134

Cited by 126 publications

(139 citation statements)

References 37 publications

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“…These conditions are known as Ambulatory Care Sensitive Conditions (ACSCs) and include, as an example, diabetes, respiratory diseases, various cardiovascular diagnoses, and convulsive disorders 36 . The protective effect of GP accessibility and the pattern of GP contact against potentially preventable hospital admissions and adverse health events has been supported by several previous studies 35, [37][38][39][40][41] . As an example, high primary care physician density appears to protect against potentially preventable hospital admissions 35 , whereas lack of a 40 , and lack of access to primary care 41 appear to lead to increase in preventable hospitalisations.…”

Section: Discussionmentioning

confidence: 60%

Regular Primary Care Plays a Significant Role in Secondary Prevention of Ischemic Heart Disease in a Western Australian Cohort

et al. 2011

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BACKGROUND: Secondary prevention for established ischaemic heart disease (IHD) involves medication therapy and a healthier lifestyle, but adherence is suboptimal. Simply having scheduled regular appointments with a primary care physician could confer a benefit for IHD patients possibly through increased motivation and awareness, but this has not previously been investigated in the literature. OBJECTIVE: To estimate the association between regular general practitioner (GP) visitation and rates of all-cause death, IHD death or repeat hospitalisation for IHD in older patients in Western Australia (WA). DESIGN: A retrospective cohort design. PARTICIPANTS: Patients aged≥65 years (n=31,841) with a history of hospitalisation for IHD from 1992-2006 were ascertained through routine health data collected on the entire WA population and included in the analysis. MAIN MEASURES: Frequency and regularity of GP visits was determined during a three-year exposure period at commencement of follow-up. A regularity score (range 0-1) measured the regularity of intervals between the GP visits and was divided into quartiles. Patients were then followed for a maximum of 11.5 years for outcome determination. Hazard ratios and 95% confidence intervals were calculated using Cox proportional hazards models. KEY RESULTS: Compared with the least regular quartile, patients with greater GP visit regularity had significantly decreased risks of all-cause death (2 nd least, 2 nd most and most regular: HR=0.76, 0.71 and 0.71); and IHD death (2 nd least, 2 nd most and most regular: HR=0.70, 0.68 and 0.65). Patients in the 2 nd least regular quartile also appeared to experience decreased risk of any repeat IHD hospitalisation (HR=0.83, 95%CI 0.71-0.96) as well as emergency hospitalisation (HR=0.81, 95%CI 0.67-0.98), compared with the least regular quartile. CONCLUSIONS: Some degree of regular GP visitation offers a small but significant protection against morbidity and mortality in older people with established IHD. The findings indicate the importance of scheduled, regular GP visits for the secondary prevention of IHD.KEY WORDS: ischemic heart disease; hospitalisations; GP visits; record linkage; primary care.

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Section: Discussionmentioning

confidence: 60%

Regular Primary Care Plays a Significant Role in Secondary Prevention of Ischemic Heart Disease in a Western Australian Cohort

et al. 2011

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“…Moreover, both these definitions identified COPD as an ambulatory care-sensitive condition. Previous studies showed that personal socioeconomic status, 23,29,30 health status, 24,31 and health care access 24,30,32 are associated with avoidable hospitalizations. To the best of our knowledge, however, few studies examined the relationship between COC and avoidable hospitalizations; the majority of these studies included several diseases, [33][34][35] but only 1 study focused on diabetes.…”

mentioning

confidence: 99%

“…23 These conditions also are called ambulatory care-sensitive conditions that could be used to reflect the quality, access, and performance of ambulatory care. 24 To date, many investigators and institutions have identified avoidable hospitalizations using a range of methods. [25][26][27][28] Among these definitions, those defined by the Agency of Healthcare Research and Quality (AHRQ) 28 and by Billings and colleagues 26 were widely used by researchers.…”

mentioning

confidence: 99%

Continuity of Care and Avoidable Hospitalizations for Chronic Obstructive Pulmonary Disease (COPD)

Lin

Huang

2015

The Journal of the American Board of Family Medicine

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Background: Numerous studied suggest that better continuity of care could result in better health outcomes. However, few studies have examined the relationship between continuity of care and avoidable hospitalizations.Methods: A retrospective cohort study design was adopted. We used secondary data analysis based on claim data regarding health care utilization under a universal coverage health insurance scheme in Tai

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“…Many of these admissions and their associated complications might be prevented through more optimal management of HF in LTC [8][9][10][11][12].…”

mentioning

confidence: 99%

Understanding organizational context and heart failure management in long term care homes in Ontario, Canada

Marcella¹,

Nadarajah²,

Kelley³

et al. 2012

Health

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Objective: To assess current heart failure (HF) care processes and organizational context in long-term care (LTC) homes as a prelude to adapting the Canadian Cardiovascular Society (CCS) HF guidelines for use in these settings. Methods: This research reports on the results of thirteen focus groups (N = 83 participants; average of 60 minutes duration) conducted in three Ontario LTC homes to better understand how HF was managed and how organizational context impacted care. Participants included physicians, nurse practitioners, registered nurses, registered practical nurses, and personal support workers. Results: Focus group findings revealed that the complexity of the LTC environment presents challenges for managing HF. Most residents have multiple advanced chronic conditions that must be managed simultaneously. Culturally, LTC is first and foremost a resident's home where residents may choose not to comply with care recommendations. Staff routines, scopes of practice, professional hierarchies, available resources and government regulations limit flexibility in providing care. Staff lacked knowledge, skills and resources for managing HF. Nevertheless, all staff viewed LTC as the preferred place for managing HF, avoiding residents' hospitalizations wherever possible. These data suggest that strategies for improving LTC staff communication and education, strengthening existing relationships between staff, family, residents and community resources, and acquiring additional resources in LTC homes have the potential to improve HF management in this setting. Conclusion: LTC is a complex and dynamic environment that presents many challenges for providing care for residents. This research provides the foundation for subsequent work to develop and test implementation strategies to manage HF in LTC, which are consistent with the CCS HF guidelines and are feasible within LTC staff's work routines, capacities and resources.

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Preventable hospitalization and access to primary health care in an area of Southern Italy

Cited by 126 publications

References 37 publications

Regular Primary Care Plays a Significant Role in Secondary Prevention of Ischemic Heart Disease in a Western Australian Cohort

Regular Primary Care Plays a Significant Role in Secondary Prevention of Ischemic Heart Disease in a Western Australian Cohort

Continuity of Care and Avoidable Hospitalizations for Chronic Obstructive Pulmonary Disease (COPD)

Understanding organizational context and heart failure management in long term care homes in Ontario, Canada

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