Identifying Potentially Avoidable Hospital Admissions From Canadian Long-Term Care Facilities

Dados Bibliográficos

ID9101675
AutoresJennifer D Walker (0000-0003-0486-6568, University of Calgary, autor correspondente), Georgia Teare (0000-0002-7655-7409, Institute for Clinical Evaluative Sciences), Gary F Teare, David B Hogan (0000-0002-9462-5460, University of Calgary), Steven Lewis (0000-0002-8796-3939, University of Calgary), Colleen J Maxwell (0000-0002-7988-2899, University of Calgary)
Ano2009
Volume47
Fascículo2
Páginas250-254
Data de publicação2009-02-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoMedical Care (JOURNAL)
Identificadores do periódicoISSN: 0025-7079 • E-ISSN: 1537-1948
EditoraOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/mlr.0b013e3181847588
PMID19169127
OpenAlexW1994163791
IdiomaEN
Citações recebidas6
Referências citadas18

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

Acute care · Ambulatory care · Environmental health · Family medicine · Health care · Intensive care medicine · Long-term care · MEDLINE · Population · Emergency Medicine · Frailty in Older Adults · Geriatric Care and Nursing Homes · Medicine · Nursing · Primary Care and Health Outcomes