Avoidable hospitalization of children from ambulatory care sensitive conditions in Barbados: a measure of the access and uptake of primary health care

IF 1.6 4区医学 Q3 PRIMARY HEALTH CARE

Primary Health Care Research and Development Pub Date : 2020-01-01 DOI:10.15761/HPC.1000197

Alok Kumar, G. Benskin, Richa Sharma

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Abstract

Background and Objective : Hospitalization from avoidable causes refers to hospitalizations for an Ambulatory Care Sensitive (ACS) condition and is considered to be a measure of access to appropriate primary health care. While not all admissions for these conditions are avoidable, timely ambulatory care could temper the disease course and thus prevent progression to where hospitalization is medically indicated. A disproportionately high rate of ACS conditions may reflect problems in access to timely primary care. In this study we determine the proportion of all medical admissions in children that were from ACS Conditions (ASSC's) and therefore avoidable. We also study the trend in the proportion of avoidable hospitalizations. Method: This study is a population based prospective clinical audit of children (Age <16 years) admitted to the Queen Elizabeth Hospital (QEH). The study period extends from the year 2013 through 2017. The pediatric-specific ACS conditions employed in this analysis were based on prior studies. All the children between the ages of 3 month and 15 years where one of the discharge diagnosis was an ACS condition were included in this study. Result: During the five years study period there were a total of 19349 children (<16 years) hospitalized for medical conditions to the QEH. Over the same period, there were a total of 4235 hospitalizations from ACSC’s which accounted for 21.89% of all medical hospitalizations in children. Among the ACSC’s as the cause of hospitalization, acute asthma (6.88%) and acute asthma complicated by respiratory tract infections (2.24%) was the commonest cause for avoidable hospitalizations in children. This was followed by admissions from acute gastroenteritis and dehydration (2.89%). Children less than 4 years in age accounted for 51% of all avoidable medical hospitalizations in children. Conclusion : Over a fifth of all the medical hospitalizations in children are from the ACSC’s and are therefore avoidable.

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在巴巴多斯，可避免的因流动护理条件敏感而住院的儿童:获得和接受初级保健的一项措施

背景和目的:可避免原因住院是指因门诊护理敏感(ACS)疾病住院，被认为是获得适当初级卫生保健的一种措施。虽然并非所有这些情况的入院都是可以避免的，但及时的门诊治疗可以缓和病程，从而防止病情发展到医学上需要住院治疗的地步。不成比例的高ACS发病率可能反映了及时获得初级保健的问题。在这项研究中，我们确定了来自ACS条件(ASSC's)的所有住院儿童的比例，因此可以避免。我们还研究了可避免住院比例的趋势。方法:本研究是对伊丽莎白女王医院(QEH)入院的儿童(年龄<16岁)进行基于人群的前瞻性临床审核。研究时间从2013年到2017年。本分析中采用的儿科特异性ACS条件是基于先前的研究。所有年龄在3个月至15岁之间且其中一项出院诊断为ACS的儿童均被纳入本研究。结果:在5年的研究期间，共有19349名儿童(<16岁)因健康状况住院。在同一时期，ACSC共有4235人住院，占所有儿童医疗住院的21.89%。在可避免的住院原因中，急性哮喘(6.88%)和急性哮喘合并呼吸道感染(2.24%)是儿童最常见的住院原因。其次是急性肠胃炎和脱水(2.89%)。在所有可避免的儿童医疗住院中，4岁以下儿童占51%。结论:在所有住院儿童中，有五分之一以上是来自ACSC，因此是可以避免的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Primary Health Care Research and Development PRIMARY HEALTH CARE-

CiteScore

2.60

自引率

6.20%

发文量

119

审稿时长

33 weeks

期刊介绍： Primary Health Care Research & Development is aimed specifically at both researchers and practitioners in primary health care, bridging the gap between the two areas. It provides a forum for the publication of international, interdisciplinary research and development in primary health care. It is essential reading for all involved in primary care: nurse practitioners, GPs and health service managers; professional and local groups in community health; researchers and academics; purchasers of primary health care services; allied health practitioners in secondary services and health-related consumer groups.