Patient and Hospital Factors Associated With Hospital Admissions for Ambulatory Care Sensitive Conditions

Abstract

Background. Patients admitted into hospitals with ambulatory care sensitive (ACS) conditions generally lack adequate primary care or are not adequately managed on an ambulatory basis. This study explored the magnitude of discharges of patients with ACS condition in American hospitals and examined patient and hospital factors associated with hospital admissions for ACS conditions. Methods. Data for this study was obtained from the 1994 National Hospital Discharge Survey. Bivariate statistical comparisons were performed to test the differences between ACS condition and non-ACS condition groups in specific demographics and hospital characteristics. Logistic regression was then applied to determine the independent effect of individual demographic and hospital factors in relation to hospitalizations for ACS conditions. Results. We found that about 12% of the hospitalized patients were discharged with ACS conditions. Hospitals likely to have a higher rate of ACS discharges were governmental, relatively small in terms of beds, and situated in the non-West region. Patients likely to be discharged with ACS conditions were older, male, African American, unmarried, without insurance, or without an expected secondary source of payment. Conclusions. Using regularly collected hospital discharge data at the national, state, and community levels, providers and decision makers can easily make timely assessments about population needs and the extent of access barriers faced by special population groups.