The Victorian Ambulatory Care Sensitive Conditions Study: reducing demand on hospital services in Victoria

Abstract

Ambulatory Care Sensitive Conditions (ACSCs) are those for which hospitalisation is thought to be avoidable if preventive care and early disease management are applied, usually in the ambulatory setting. The Victorian ACSCs study offers a new set of indicators describing differentials and inequalities in access to the primary healthcare system in Victoria. The study used the Victorian Admitted Episodes Dataset (1999-2000) for analysing hospital admissions for diabetes complications, asthma, vaccine preventable influenza and pneumococcal pneumonia. The analyses were performed at the level of Primary Care Partnerships (PCPs). There were 12,100 admissions for diabetes complications in Victoria. There was a 12-fold variation in admission rates for diabetes complications across PCPs, with 13 PCPs having significantly higher rates than the Victorian average, accounting for just over half of all admissions (6114) and 39 per cent total bed days. Similar variations in admission rates across PCPs were observed for asthma, influenza and pneumococcal pneumonia. This analysis, with its acknowledged limitations, has shown the potential for using these indicators as a planning tool for identifying opportunities for targeted public health and health services interventions in reducing demand on hospital services in Victoria.

The National Health Survey 2001: usefulness to inform a discussion on access to and use of quality primary health care using type 2 diabetes mellitus as an example

“…20 In these data it was not possible to identify admissions that were specifically related to diabetes, but diabetes is a major contributor to hospitalisation. 21 A fifth of participants reported hospitalisation within the last 12 months.…”

Rates of admission for ambulatory care sensitive conditions in France in 2009–2010: trends, geographic variation, costs, and an international comparison

“…In Canada, evaluation of a limited sample of ACSCs found that higher community affluence and not living in a rural setting were associated with lower rates of admission for ACSCs [11]. An Australian study found a 12-fold variation in admission rates for diabetes complications and similar variation in admission rates for asthma, influenza and pneumococcal pneumonia [12]; there, lower income, educational achievement, and self-rated health status were associated with higher rates of admission for ACSCs [13]. An evaluation of admission for several chronic ACSCs in four large Italian cities showed that poorer people, females, and older people in the sample were more likely to be admitted for ACSCs [14].…”

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

“…The concept has also been adopted and modified by countries outside the USA, including Australia [15][16][17][18].…”

“…Incidence rates varied depending on the study population, with 2.4-3.6% of all hospital admissions being drug related, [15][16][17][18][19][20][21][22] …”