Abstract
Hospitalizations for ambulatory care sensitive conditions have been extensively used in health services research to assess access, quality and performance of primary health care. Inter-country comparisons can assist policy-makers in pursuing better health outcomes by contrasting policy design, implementation and evaluation. The objective of this study is to identify the conceptual, methodological, contextual and policy dimensions and factors that need to be accounted for when comparing these types of hospitalizations across countries. A conceptual framework for inter-country comparisons was drawn based on a review of 18 studies with inter-country comparison of ambulatory care sensitive conditions hospitalizations. The dimensions include methodological choices; population’s demographic, epidemiologic and socio-economic profiles and features of the health services and system. Main factors include access and quality of primary health care, availability of health workforce and health facilities, health interventions and inequalities. The proposed framework can assist in designing studies and interpreting findings of inter-country comparisons of ambulatory care sensitive conditions hospitalizations, accelerating learning and progress towards universal health coverage.
Highlights
IntroductionIt is commonly accepted that, for some health conditions, timely and adequate management, treatment and interventions delivered in the outpatient setting could potentially avoid the need for hospitalization
It is commonly accepted that, for some health conditions, timely and adequate management, treatment and interventions delivered in the outpatient setting could potentially avoid the need for hospitalization. These conditions are known as ambulatory care sensitive conditions (ACSC) and they have been widely used as an indicator of access, quality and performance of primary health care and overall health services [1,2,3,4]
Responsive primary health care associated to lower rates of ACSC hospitalizations
Summary
It is commonly accepted that, for some health conditions, timely and adequate management, treatment and interventions delivered in the outpatient setting could potentially avoid the need for hospitalization. These conditions are known as ambulatory care sensitive conditions (ACSC) and they have been widely used as an indicator of access, quality and performance of primary health care and overall health services [1,2,3,4]. There is evidence that features related to access, quality, integration and efficiency of services are positively associated with ambulatory care sensitive conditions hospitalizations (ACSC hospitalizations) [5]. ACSC hospitalizations are positively associated with deprivation, unemployment, scarce education attainments, low level of income and rurality [8,9,18,19]
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