How multiple chronic conditions increase the risk of ACSC hospitalizations

Abstract

Introduction : The high financial burden of avoidable hospitalizations has led to an increase of the study of hospitalizations for ambulatory care sensitive conditions (ACSC). Although patients’ social and demographic characteristics are frequently identified in the literature as factors that increase the risk of an avoidable hospitalization, there is little information on the impact of multiple chronic conditions on these hospitalizations. Our study looks for the relationship between multiple chronic conditions and ACSC hospitalizations. Theory/Methods : Data consists of all hospitalizations in the portuguese health system between 2008 and 2012. Avoidable hospitalizations were identified according to the Canadian Institute for Healthcare Information and chronic conditions were identified according to criteria set by the Agency for Healthcare Research and Quality. A retrospective study analyzing all patients hospitalized for an ACSC and all patients hospitalized for non-ACSC was made, using different multiple logistic regression models to identify the impact of chronic conditions in the risk of admission. Results : We found that the population with ACSC hospitalizations when compared to the population with non-ACSC hospitalizations has in average more chronic conditions (3.93 to 1.98, p=0.008) and chronic conditions in more body systems (2.50 to 1.49, p=0.00419). We observed that the probability of an ACSC hospitalization increases 1.35 times (p Conclusion : The number of chronic conditions and the type of body systems affected increases the risk of admission for ACSC. Further investigation needs to follow in order to develop risk models that help both identify these patients in higher risk of an avoidable hospitalization and promote a more assertive use of ACSC as measure of access to care.