The Concept and Usefulness of Ambulatory Care Sensitive Conditions as Indicators of Quality and Access to Primary Health Care

Abstract

The purpose of this review is to introduce health services researchers, especially in the area of primary health care, to the meaning and concept of ambulatory care sensitive conditions (ACSCs). More specifically, this review explores the validity of ACSC admissions as proxy indicators of access to primary health care, provides a description of the factors that cause variations in ACSC admission rates, and presents a discussion of the potential usefulness and policy implications of these indicators for primary health care. Critical Interpretive Synthesis (CIS) methodology was used to review the literature on ACSC admissions indicators. Medline and Australasian Medical Index were searched for English language articles published between 1970 and August 2005. The results were supplemented by an internet search of the World Wide Web, further augmented by manual scans of material from deeper levels within the sites. Main finding from the review indicates that ACSC admissions are valid proxy indicators of access to primary health care. Socioeconomic factors are most important in explaining variations in ACSC admissions. Several uses and policy implications of ACSC admission indicators are discussed, including their potential for identifying gaps in the primary health care system and providing opportunities for targeted public health and health services interventions.

Understanding 30‐day re‐admission after hospitalisation of older patients for diabetes: identifying those at greatest risk

“…An Australian literature review by Ansari (2007) explored the concept of ACSC, and provided a comprehensive description of the factors affecting variations in rates of ACSC related hospitalisations.…”

“…The literature review provides strong evidence for the relationship between a number of factors which have a direct or indirect impact on PPH rates [1,4,43,44].…”

Condições Sensíveis À Atenção Primária: Confiabilidade Diagnóstica Em Santa Cruz Do Sul, Rs

“…Após a análise do prontuário, a prevalência de CSAP em toda a amostra passou a 31,9% (IC95% 27, 8). Como mostra a Tabela 1, foi maior entre os menores de 15 anos (57,0%, IC95% 47,7-66,0) e nas internações pediátricas (63,6%, IC95% 53,7-72,6).…”

“…No Brasil, as Bases de Dados do Sistema de Internação Hospitalar do SUS (BD-SIH/SUS), com informações da Autorização de Internação Hospitalar (AIH) são amplamente utilizadas na pesquisa, planejamento e gestão de saúde, o que sugere o reconhecimento de certa validade da informação. 1,4,[7][8][9]11 Entretanto, a acurácia diagnóstico principal da internação nos registros do SIH/SUS é pouco conhecida e há poucos estudos a respeito nas revistas científicas indexadas. Apenas um dos quatro estudos encontrados foi realizado após a criação do SUS, e não encontramos estudos sobre a confiabilidade do indicador CSAP no SIH/ SUS.…”

The financial and health burden of diabetic ambulatory care sensitive hospitalisations in Mexico

“…These avoidable hospitalisations -ambulatory care sensitive hospitalisations (ACSHs)-have been widely used to study the access to, quality and effectiveness of primary care services. 1,2 While the financial implications of ACSHs have been studied before for some countries, the preventable losses of health as a consequence of ACSHs have not received attention in the literature. This paper estimates the financial cost of ACSHs in public general hospitals in Mexico and proposes a way to quantify the health burden associated with them.…”