Emergency Department Visits for Ambulatory Care Sensitive Conditions
Insights Into Preventable Hospitalizations
Bibliographic Data
| ID | 9102442 |
|---|---|
| Authors | Ady Oster (San Francisco General Hospital), Andrew B Bindman (0000-0002-6161-0609, San Francisco General Hospital, corresponding author) |
| Year | 2003 |
| Volume | 41 |
| Issue | 2 |
| Pages | 198-207 |
| Publication date | 2003-02-01 |
| Open Access | No |
| Type | ARTICLE |
| Venue | Medical Care (JOURNAL) |
| Journal identifiers | ISSN: 0025-7079 • E-ISSN: 1537-1948 |
| Publisher | Ovid Technologies (Wolters Kluwer Health) (PUBLISHER) |
| DOI | 10.1097/01.mlr.0000045021.70297.9f |
| PMID | 12555048 |
| OpenAlex | W2076185346 |
| Language | EN |
| Citations received | 40 |
| References cited | 18 |
OBJECTIVES: To explore whether differences in disease prevalence, disease severity, or emergency department (ED) admission thresholds explain why black persons, Medicaid, and uninsured patients have higher hospitalization rates for ambulatory care sensitive (ACS) conditions. MATERIALS AND METHODS: The National Hospital Ambulatory Care Survey was used to analyze the ED utilization, disease severity (assessed by triage category), hospitalization rates, and follow-up plans for adults with five chronic ACS conditions (asthma, chronic obstructive lung disease, congestive heart failure, diabetes mellitus, and hypertension). The National Health Interview Survey was used to estimate the prevalence of these conditions in similarly aged US adults. RESULTS: Black persons, Medicaid, and uninsured patients make up a disproportionate share of ED visits for these chronic ACS conditions. Cumulative prevalence of these conditions was higher in black persons (33%) compared with white persons (27%) and Hispanic persons (22%), but did not differ among the payment groups. All race or payment groups were assigned to similar triage categories and similar percentages of their ED visits resulted in hospitalization. Black persons and Hispanic persons (odds ratios for both = 0.7), were less likely than white persons, whereas Medicaid and uninsured patients (odds ratios for both = 0.8), were less likely than private patients to have follow-up with the physician who referred them to the ED. CONCLUSIONS: The disproportionate ED utilization for chronic ACS conditions by black persons and Medicaid patients does not appear to be explained by either differences in disease prevalence or disease severity. Follow-up arrangements for black persons, Medicaid, and uninsured patients suggest that they are less likely to have ongoing primary care. Barriers to primary care appear to contribute to the higher ED and hospital utilization rates seen in these groups
Ambulatory · Ambulatory care · Asthma · Diabetes mellitus · Disease · Emergency department · Environmental health · Health care · Logistic regression · Medicaid · National Health Interview Survey · Odds · Odds ratio · Population · Psychiatry · Triage · Chronic Disease Management Strategies · Emergency and Acute Care Studies · Emergency Medicine · Internal Medicine · Medicine · Primary Care and Health Outcomes
Does healthcare inequity reflect variations in peoples’ abilities to access healthcare? Results from a multi-jurisdictional interventional study in two high-income countries
Social factors in frequent callers
Income level and chronic ambulatory care sensitive conditions in adults
HIV/Aids Health Service Utilization by People Who have been Homeless
Correlates of HIV Testing Refusal Among Emergency Department Patients in the Opt-Out Testing Era
Factors Associated with Refusal of Rapid HIV Testing in an Emergency Department
Hospital Emergency Departments
Characteristics of Individuals With Severe Mental Illness Who Use Emergency Services
Suicide Risk and Mental Health Co-morbidities in a Probationer Population
Factors Associated with Reluctance to Use an Emergency Department in a Multi-ethnic Community
Changes in Medicaid Physician Fees and Patterns of Ambulatory Care
Medical Bankruptcy in the United States, 2007
Performing Through Privatization
Social determinants of health and rehabilitation service areas
The dynamic interdependence in the demand of primary and emergency secondary care
Access to outpatient care in Manhattan and Paris
Does Spending More Get More? Health Care Delivery and Fiscal Implications From a Medicare Fee Bump
Older Adults’ Inpatient and Emergency Department Utilization for Ambulatory-Care-Sensitive Conditions
Pain in Community-Dwelling Elderly African Americans
Evaluating Access to Primary Health Care Among Older Women and Men in Barbados Using Preventable Hospitalization
Measuring Health Equity for Ambulatory Care Sensitive Conditions in a Large Integrated Health Care System
Racial and Ethnic Disparities in Hospital-Based Care Among Dual Eligibles Who Use Health Centers
The Relationship Between Rural Health Clinic Use and Potentially Preventable Hospitalizations and Emergency Department Visits Among Medicare Beneficiaries
Presence of a Community Health Center and Uninsured Emergency Department Visit Rates in Rural Counties
Why do patients with long-term conditions use unscheduled care? A qualitative literature review
Secondary Surge Capacity
Health Insurance and Mortality in US Adults
Reducing Costs of Acute Care for Ambulatory Care-sensitive Medical Conditions
The Vexing Problem of Health Inequalities in the United States
Changes in Preventative Health Care After Medicaid Expansion
Emergency Department Visits and Primary Care Among Adults With Chronic Conditions
Characteristics of Occasional and Frequent Emergency Department Users
Work-related Asthma, Financial Barriers to Asthma Care, and Adverse Asthma Outcomes
Mental Comorbidity and Quality of Diabetes Care Under Medicaid
The Effect of Medicare Health Maintenance Organizations on Hospitalization Rates for Ambulatory Care-Sensitive Conditions
Preventable Hospitalizations Among Children in California Counties After Child Health Insurance Expansion Initiatives
Medicaid Managed Care in Florida and Racial and Ethnic Disparities in Preventable Emergency Department Visits
Frequency and Predictors of Adverse Health Outcomes in Older Medicare Beneficiaries Discharged From the Emergency Department
Evaluating the Impact of Integrated Care on Service Utilization in Serious Mental Illness
Racial and ethnic disparities in hospital care resulting from air pollution in excess of federal standards
Preventable Hospitalizations and Access to Health Care
Impact Of Socioeconomic Status On Hospital Use In New York City
Delayed Access to Health Care
Rates of Avoidable Hospitalization by Insurance Status in Massachusetts and Maryland
Potentially avoidable hospitalizations
Primary care and public emergency department overcrowding
Nonurgent Emergency Department Visits
Factors Related to Potentially Preventable Hospitalizations Among the Elderly
Ambulatory Care Sensitive Hospitalizations and Emergency Visits
Hospitalization for Ambulatory Care-Sensitive Conditions
| Citations per year | 1.74 |
|---|---|
| Citation span | 2003 - 2025 (23) |
| Highly cited | No |