期刊
MEDICAL CARE
卷 47, 期 2, 页码 250-254出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MLR.0b013e3181847588
关键词
long-term care; preventive health services; continuity of care; quality indicator; hospitalization
类别
资金
- Canadian Institutes for Health Research (CIHR) [74729]
- Alberta Heritage Foundation forMedical Research (AHFMR).
- CIHR New Investigator and AHFMR Health Scholar Awards
- Brenda Strafford Foundation
Background: The provision of preventive services and continuity of care are important aspects of long-term care (LTC). A proposed quality indicator of such care is the rate of hospitalizations due to ambulatory care sensitive conditions (ACSCs). As the ACSC approach to identifying potentially avoidable hospitalizations (PAH) was developed for younger community-dwelling adults in the United States, we sought to examine its applicability as a quality indicator for older institutionalized residents in Canada. Methods: ACSCs were identified in a linked hospital-based LTC and acute care administrative database at the Institute for Clinical Evaluative Sciences in Ontario, Canada. An expert panel was then convened to assess the applicability of existing ACSCs to an older institutionalized population in Canada and to develop consensus-based revisions appropriate to this setting. The revised definition of PAH was then applied to the same linked database. Results: The proportion of hospitalizations categorized as a PAH using the original ACSCs was 47% (4177 of 8885). The panel suggested the inclusion of 2 new conditions (septicemia and falls/fractures) coupled with the deletion of 4 of the original ACSCs (immunization-preventable conditions; nutritional deficiency, severe ear, nose and throat infections; tuberculosis) that were rare hospital diagnoses in this population. Using the revised definition, 55% of hospitalizations (4874) were identified as potentially avoidable. Conclusions: Changes to the original list of ACSCs led to more hospitalizations being categorized as potentially avoidable. Significant variation between LTC facilities and over time in our PAH indicator may identify areas for improvement in preventive services and continuity of care for LTC residents.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据