Avoidable Hospitalization Trends From Ambulatory Care-Sensitive Conditions in the Public Health System in México

Bibliographic Data

ID22071063
AuthorsOfelia Poblano Verástegui (Instituto Nacional de Salud Pública), Laura del Pilar Torres-Arreola, Laura del Pilar Torres‐Arreola (Instituto Nacional de Salud Pública, corresponding author), Sergio Flores-Hernández, Sergio Flores‐Hernández (0000-0001-5773-9234, Instituto Nacional de Salud Pública, corresponding author), ARMANDO NEVÁREZ SIDA, Armando Nevárez-Sida (0000-0002-1007-3268, Mexican Social Security Institute), Pedro J Hernández (0000-0002-5414-1250, Instituto Nacional de Salud Pública), Pedro J Saturno Hernández
Year2022
Volume9
Pages765318-765318
Publication date2022-01-21
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2021.765318
PMID35127618
OpenAlexW4206547420
LanguageEN
References cited31

OBJECTIVES: To estimate and identify the variations in rates of Avoidable Hospitalization for Ambulatory Care Sensitive Conditions (AH-ACSC) in public institutions of the Mexican health system during the period 2010-2017. METHODS: Secondary analysis of the hospital discharge database of the Ministry of Health (MoH) from 2010 to 2017. AH for ACSC was calculated by age group and sex per 100,000. Variations per year between institutions were calculated with the extreme quotient (EQ), coefficient of variation (CV) and systematic component of variance (SCV). Adjusted AH rates were calculated by group of causes (acute, chronic and preventable by vaccination). Adjusted AH trend rates were analyzed by Join Point Regression. RESULTS: For the period 2010-2017, the number of AH for ACSC decreased from 676,705 to 612,897, going from almost 13% to 10.7% of hospital discharges. There is consistency in terms of relative variance magnitude. But, with regards to SCV, the change remained constant, and in a second period of 2015-2017, high variation was observed by SCV ≥ 3. All-cause AH is diminishing in all institutions. AH rates for diabetes are the highest, but like other chronic diseases, there was a decline in the period from 2010 to 2017. The relative reduction varied from 15% for heart failure to 38% for complications from diabetes or hypertension, to 75% for angina. CONCLUSIONS: AH for ACSC is an indirect indicator of quality and access to first-level care. Variations by institutions are observed. This variation in CV and SCV across subsystems and states may be due to inequities in the provision of services. The factors that contribute to the burden of AH for ACSC in the Mexican Health System require detailed analysis

Ambulatory · Ambulatory care · Environmental health · Health care · Medical emergency · Political science · Public health · Chronic Disease Management Strategies · Healthcare Systems and Reforms · Medicine · Nursing · Primary Care and Health Outcomes · Internal Medicine

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