Abstract
BackgroundAmbulatory Care Sensitive Conditions (ACSCs) are those for which hospitalisation is thought to be avoidable with the application of preventive care and early disease management, usually delivered in a primary care setting. ACSCs are used extensively as indicators of accessibility and effectiveness of primary health care. We examined the association between patient characteristics and hospitalisation for ACSCs in the adult and paediatric population in Victoria, Australia, 2003/04.MethodsHospital admissions data were merged with two area-level socioeconomic indexes: Index of Socio-Economic Disadvantage (IRSED) and Accessibility/Remoteness Index of Australia (ARIA). Univariate and multiple logistic regressions were performed for both adult (age 18+ years) and paediatric (age <18 years) groups, reporting odds ratios (OR) and 95% confidence intervals (CI) for a number of predictors of ACSCs admissions compared to non-ACSCs admissions.ResultsPredictors were much more strongly associated with ACSCs admissions compared to non-ACSCs admissions in the adult group than for the paediatric group with the exception of rurality. Significant adjusted ORs in the adult group were 1.06, 1.15, 1.13, 1.06 and 1.11 for sex, rurality, age, IRSED and ARIA variables, and 1.34, 1.04 and 1.09 in the paediatric group for rurality, IRSED and ARIA, respectively.ConclusionsDisadvantaged paediatric and adult population experience more need of hospital care for ACSCs. Access barriers to primary care are plausible causes for the observed disparities. Understanding the characteristics of individuals experiencing access barriers to primary care will be useful for developing targeted interventions meeting the unique ambulatory needs of the population.
Highlights
Ambulatory Care Sensitive Conditions (ACSCs) are those for which hospitalisation is thought to be avoidable with the application of preventive care and early disease management, usually delivered in a primary care setting
A lower proportion (29.6%) of patients lived in rural areas compared to metropolitan areas. 3.3% of patients lived in ARIA 3 and 19.6%
The crude admission rates for both ACSCs and non-ACSCs increased with age among the adult population, and decreased with age among the paediatric group (Table 2)
Summary
Ambulatory Care Sensitive Conditions (ACSCs) are those for which hospitalisation is thought to be avoidable with the application of preventive care and early disease management, usually delivered in a primary care setting. ACSCs are used extensively as indicators of accessibility and effectiveness of primary health care. Ambulatory Care Sensitive Conditions (ACSCs) are those for which hospitalisation is thought to be avoidable with the application of preventive care and early disease management, usually delivered in an primary care setting [1,2,3,4]. Timely and effective ambulatory care can reduce the risks of hospitalisation by preventing the onset of an illness or condition; controlling an acute episodic illness or condition; or managing a ACSCs have been used extensively as an indicator of accessibility and overall effectiveness of primary health care, such that the rate of hospitalisation for ACSCs is higher in communities with poor access to ambulatory care [2,3,7,8,9]. Older age groups (65+) have been studied extensively in the US, with significant increases in the rates of ACSCs admissions in this age category between 1980 and 1998 [23]
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