Abstract
BackgroundAmbulatory care sensitive conditions (ACSC) hospitalization is a widely accepted measure of the access to primary care. However, given its discretionary characteristics, the ACSC hospitalization can be a measure reflecting the influence of hospital bed supply. In Korea, where the quality of primary care and oversupply of hospital beds are coexistent concerns, ACSC hospitalization can be used to examine the impact of both factors. This study was performed to investigate the ACSC hospitalization rate as a measure of the hospital bed supply as well as access to primary care.MethodsData were obtained from the National Health Insurance Database for 2015. We calculated the age-sex standardized hospitalization rates for ACSC in the total population and crude rates of ACSC hospitalization for three different age groups in 252 districts in Korea. We calculated the variation statistics of ACSC hospitalization rates, and we estimated a linear regression model to investigate the factors for ACSC hospitalization.ResultsThere was a very high geographic variation in ACSC hospitalization rates. Higher density of primary care physicians was associated with a decreased ACSC hospitalization rate while a higher density of hospital beds in small to medium sized hospitals was associated with an increased rate. The deprivation index score had a strongly positive association with the ACSC hospitalization rates.ConclusionACSC hospitalization, while being a negative index of primary care access, can also be a measure indicating the impact of the hospital bed supply, and it is still a valid measure of the disparity of health care, the original motivation for this topic.
Highlights
Ambulatory care sensitive conditions (ACSC) hospitalization is a widely accepted measure of the access to primary care
We found that the coefficient of variation (CV) and systematic component of variation (SCV) in the ACSC hospitalization rates were markedly higher than the other medical procedures, such as percutaneous transluminal coronary angioplasty, surgery after hip fracture, knee-replacement surgery, cesarean section, hysterectomy, computed tomography scan, and magnetic resonance imaging scan
ACSC hospitalization, while being a negative index of primary care access, can be a measure indicating the impact of the hospital bed supply, and it is still valid as a measure of the inequality of health care
Summary
Ambulatory care sensitive conditions (ACSC) hospitalization is a widely accepted measure of the access to primary care. Given its discretionary characteristics, the ACSC hospitalization can be a measure reflecting the influence of hospital bed supply. This study was performed to investigate the ACSC hospitalization rate as a measure of the hospital bed supply as well as access to primary care. Hospitalization for ambulatory care sensitive conditions (ACSC) is a widely accepted measure of the function of primary care. ACSC hospitalization, on the other hand, can be an indicator of the influence of hospital bed supply. This is due to the discretionary characteristics which are inherent in the concept of ACSC as well as in hospitalization. As ACSC hospitalization has been mainly investigated in terms of primary care, hospital bed supply did not receive much attention, and its impact on the ACSC hospitalization remains less investigated [3, 14]
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