POTENTIALLY PREVENTABLE HOSPITALIZATIONS OF THE ADULT POPULATION UKRAINE ASSOCIATED WITH AMBULATORY CARE SENSITIVE CONDITIONS
About the author:
Lekhan V. M., Kriachkova L. V., Serdyuk V. M., Puchkova N. V., Maksimenko O. P., Kozyr O. A., Kiy-Kokareva V. G., Kolesnik V. I.
SOCIAL MEDICINE AND ORGANIZATION OF HEALTHCARE PROTECTION
Type of article:
The purpose of the study is to determine the potentially preventable hospitalization associated with Ambulatory care sensitive conditions (ACSC) for the adult population of Ukraine while improving the effectiveness of primary care. Object and methods. The study was conducted as a second phase after determining the general list and markers ACSC for the adult population of Ukraine ACSC study in Ukraine using adapted to the national context of the WHO guidelines for assessing ACSC and the potentially preventable hospitalization in the European region. 77 respondents – general practitioners and a group of experts were interviewed using a standardized questionnaire. Results. The potential possibility of a significant reduction in hospitalizations for the entire set of ACSC, identified as significant for Ukraine, with the exception of iron deficiency anemia and chronic heart failure, has been identified. The largest population indicators of probable preventable of hospitalizations are registered in arterial hypertension, pneumonia, angina, COPD and diabetes, which coincides with the list of the most significant for the adult population of Ukraine ACSC. The general level of potential preventable of hospitalization of adults from ACSC, determined for the population, in Ukraine is according to doctors – 28.2%, according to expert estimates – 32.9%, which may reduce the total hospitalization for outpatient-sensitive conditions (in% from the number of patients with ACSC) from 8.1% to 6.0% (according to PPE estimates) or up to 5.6 % (according to experts). Conclusions. The results obtained for the potentially preventable hospitalisation from ACSC, defined for the population, can be seen as a potential for change management and can be used in the development of general policies or specific programs in the field of health and strengthening PHC systems.
ambulatory care sensitive conditions (ACSC), potentially preventable hospitalization, primary care.
- Carter R, Riverin B, Levesque JF, Gariepy G, Quesnel-Vallée A. The impact of primary care reform on health system performance in Canada: a systematic review. BMC Health Serv Res. 2016;16:324. Published 2016 Jul 30. DOI: 10.1186/s12913-016-1571-7
- Carneiro CS. Hospitalisation of ambulatory care sensitive conditions and access to primary care in Portugal. P Public Health. 2018 Dec;165:117-24. DOI: 10.1016/j.puhe.2018.09.019
- Phua J, Weng L, Ling L, Egi M, Lim CM, Divatia JV, et al. Intensive care management of coronavirus disease 2019 (COVID-19): challenges and recommendations. The Lancet. Respiratory medicine. 2020;8(5):506-17. Available from: https://doi.org/10.1016/S2213- 2600(20)30161-2
- Chang JJ, Chen YC, Gao HX, Zhang Y, Li HM, Su D, et al. Effect of inappropriate admissions on hospitalization performance in county hospitals: a cross-sectional study in rural China. Cost Eff Resour Alloc. 2019;17:8. Published 2019 Apr 2. DOI: 10.1186/s12962-019-0176-5
- Rahimi H, Ostovar R, Vali L, Angha P. Investigating inappropriate admissions and hospitalizations in Yasuj educational hospitals based on appropriateness evaluation protocol (AEP): A case study in the internal and surgical wards. Int J Health Plann Manage. 2019 Apr;34(2):636- 43. DOI: 10.1002/hpm.2723
- Zuckerman RB, Sheingold SH, Orav EJ, Ruhter J, Epstein AM. Readmissions, Observation, and the Hospital Readmissions Reduction Program. N Engl J Med. 2016 Apr 21;374(16):1543-51. DOI: 10.1056/NEJMsa1513024
- Longman JM, Passey ME, Ewald DP, Rix E, Morgan GG. Admissions for chronic ambulatory care sensitive conditions – a useful measure of potentially preventable admission? BMC Health Serv Res. 2015;15:472. Published 2015 Oct 16. DOI: 10.1186/s12913-015-1137-0
- Purdy S, Griffin T, Salisbury C, Sharp D. Ambulatory care sensitive conditions: terminology and disease coding need to be more specific to aid policy makers and clinicians. Public Health. 2009 Feb;123(2):169-73. DOI: 10.1016/j.puhe.2008.11.001
- Fransoo R, Martens P, Prior H, Burchill С, Koseva І, Allegro Е. The 2013 RHA Indicators Atlas. Winnipeg, MB: Manitoba Centre for Health Policy. 2013;203-6. Available from: http://mchp-appserv.cpe.umanitoba.ca/reference/RHA_2013_web_version.pdf
- Pinto LF, Giovanella L. The Family Health Strategy: expanding access and reducing hospitalizations due to ambulatory care sensitive conditions (ACSC). Cien Saude Colet. 2018 Jun;23(6):1903-14. DOI: 10.1590/1413-81232018236.05592018
- Assessing health services delivery performance with hospitalizations for ambulatory care sensitive conditions. World Health Organization. Copenhagen: WHO Regional Offce for Europe; 2016. 43 р.
- Lekhan VM, Kryachkova LV, Zayarskyy MI, Borvinko EV. Ukrayinska versiya protokolu otsinky obgruntovanosti hospitalizatsiyi ta yiyi tryvalosti. Svit medytsyny ta biolohiyi. 2019;3:94-9. DOI: 10.26724/2079-8334-2019-3-69-94-100. [in Ukrainian].
- Zhao F, Doroshenko O, Lekhan VN, Kriachkova LV, Goroshko A. Assessment of appropriateness of hospitalisations in Ukraine: analytical framework, method and findings. BMJ Open. 2019;9(12):e030081. Published 2019 Dec 8. DOI: 10.1136/bmjopen-2019-030081
- Lekhan VM, Kryachkova LV, Serdyuk VM. Otsinka vazhlyvosti problemy zakhvoryuvan, shcho piddayutsya ambulatornomu likuvannyu v Ukrayini. Ukrayina. Zdorovya natsiyi. 2020;2(59):7-17. DOI: 10.24144/2077-6594.2.2020. 201618. [in Ukrainian].
- Sundmacher L, Fischbach D, Schuettig W, Naumann C, Augustin U, Faisst C. Which hospitalisations are ambulatory care-sensitive, to what degree, and how could the rates be reduced? Health Policy. 2015 Nov;119(11):1415-23. DOI: 10.1016/j.healthpol.2015.08.007
- Santana R, Santos RF, Sarmento J, Lopes S, Barbazza E, Tello J. Determinants of ambulatory care sensitive conditions hospitalizations – the patients’ perspective. International Journal of Integrated Care. 2018;18:376. DOI: 10.5334/ijic.s2376
Publication of the article:
«Bulletin of problems biology and medicine» Issue 2 (156), 2020 year, 319-324 pages, index UDK 614.2: 616-08-039.57 (477)