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Admissions for ambulatory care sensitive conditions on rural islands and their association with patient experience: a multicentred prospective cohort study
OBJECTIVES: The rate of admissions for ambulatory care sensitive conditions (ACSCs) is a key outcome indicator for primary care, and patient experience (PX) is a crucial process indicator. Studies have reported higher rates of admission for ACSCs in rural areas than in urban areas. Whether there is...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936984/ https://www.ncbi.nlm.nih.gov/pubmed/31888923 http://dx.doi.org/10.1136/bmjopen-2019-030101 |
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author | Kaneko, Makoto Aoki, Takuya Funato, Masafumi Yamashiro, Keita Kuroda, Kaku Kuroda, Moe Saishoji, Yusuke Sakai, Tatsuya Yonaha, Syo Motomura, Kazuhisa Inoue, Machiko |
author_facet | Kaneko, Makoto Aoki, Takuya Funato, Masafumi Yamashiro, Keita Kuroda, Kaku Kuroda, Moe Saishoji, Yusuke Sakai, Tatsuya Yonaha, Syo Motomura, Kazuhisa Inoue, Machiko |
author_sort | Kaneko, Makoto |
collection | PubMed |
description | OBJECTIVES: The rate of admissions for ambulatory care sensitive conditions (ACSCs) is a key outcome indicator for primary care, and patient experience (PX) is a crucial process indicator. Studies have reported higher rates of admission for ACSCs in rural areas than in urban areas. Whether there is an association between admissions for ACSCs and PX in rural areas has not been examined. This study aimed to document admissions for ACSCs on Japanese rural islands, and assess whether there was an association between the rate of admissions for ACSCs and PX. DESIGN: Multicentred, prospective, cohort study SETTING: This study was conducted on five rural islands in Okinawa, Japan. PARTICIPANTS: The study participants were all island inhabitants aged 65 years or older. PRIMARY OUTCOME MEASURES: This study examined the association between ACSCs and PX assessed by a questionnaire, the Japanese Version of Primary Care Assessment Tool. ACSCs were classified using the International Classification of Diseases, Tenth Revision, and the rate of admissions for ACSCs in 1 year. RESULTS: Of 1258 residents, 740 completed the questionnaire. This study documented 38 admissions for ACSCs (29 patients, males/females: 15/14, median age 81.9) that included congestive heart failure (11), pneumonia (7) and influenza (5). After adjusting for covariates and geographical clustering, admissions for ACSCs had a significant positive association with each patient’s PX scores (OR per 1 SD increase=1.62, 95% CI 1.02–2.61). CONCLUSIONS: Physicians serving rural areas need to stress the importance of preventive interventions for heart failure, pneumonia and influenza to reduce the number of admissions for ACSCs. Contrary to previous studies, our findings might be explained by close patient–doctor relationships on the rural islands. |
format | Online Article Text |
id | pubmed-6936984 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-69369842020-01-06 Admissions for ambulatory care sensitive conditions on rural islands and their association with patient experience: a multicentred prospective cohort study Kaneko, Makoto Aoki, Takuya Funato, Masafumi Yamashiro, Keita Kuroda, Kaku Kuroda, Moe Saishoji, Yusuke Sakai, Tatsuya Yonaha, Syo Motomura, Kazuhisa Inoue, Machiko BMJ Open General practice / Family practice OBJECTIVES: The rate of admissions for ambulatory care sensitive conditions (ACSCs) is a key outcome indicator for primary care, and patient experience (PX) is a crucial process indicator. Studies have reported higher rates of admission for ACSCs in rural areas than in urban areas. Whether there is an association between admissions for ACSCs and PX in rural areas has not been examined. This study aimed to document admissions for ACSCs on Japanese rural islands, and assess whether there was an association between the rate of admissions for ACSCs and PX. DESIGN: Multicentred, prospective, cohort study SETTING: This study was conducted on five rural islands in Okinawa, Japan. PARTICIPANTS: The study participants were all island inhabitants aged 65 years or older. PRIMARY OUTCOME MEASURES: This study examined the association between ACSCs and PX assessed by a questionnaire, the Japanese Version of Primary Care Assessment Tool. ACSCs were classified using the International Classification of Diseases, Tenth Revision, and the rate of admissions for ACSCs in 1 year. RESULTS: Of 1258 residents, 740 completed the questionnaire. This study documented 38 admissions for ACSCs (29 patients, males/females: 15/14, median age 81.9) that included congestive heart failure (11), pneumonia (7) and influenza (5). After adjusting for covariates and geographical clustering, admissions for ACSCs had a significant positive association with each patient’s PX scores (OR per 1 SD increase=1.62, 95% CI 1.02–2.61). CONCLUSIONS: Physicians serving rural areas need to stress the importance of preventive interventions for heart failure, pneumonia and influenza to reduce the number of admissions for ACSCs. Contrary to previous studies, our findings might be explained by close patient–doctor relationships on the rural islands. BMJ Publishing Group 2019-12-29 /pmc/articles/PMC6936984/ /pubmed/31888923 http://dx.doi.org/10.1136/bmjopen-2019-030101 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | General practice / Family practice Kaneko, Makoto Aoki, Takuya Funato, Masafumi Yamashiro, Keita Kuroda, Kaku Kuroda, Moe Saishoji, Yusuke Sakai, Tatsuya Yonaha, Syo Motomura, Kazuhisa Inoue, Machiko Admissions for ambulatory care sensitive conditions on rural islands and their association with patient experience: a multicentred prospective cohort study |
title | Admissions for ambulatory care sensitive conditions on rural islands and their association with patient experience: a multicentred prospective cohort study |
title_full | Admissions for ambulatory care sensitive conditions on rural islands and their association with patient experience: a multicentred prospective cohort study |
title_fullStr | Admissions for ambulatory care sensitive conditions on rural islands and their association with patient experience: a multicentred prospective cohort study |
title_full_unstemmed | Admissions for ambulatory care sensitive conditions on rural islands and their association with patient experience: a multicentred prospective cohort study |
title_short | Admissions for ambulatory care sensitive conditions on rural islands and their association with patient experience: a multicentred prospective cohort study |
title_sort | admissions for ambulatory care sensitive conditions on rural islands and their association with patient experience: a multicentred prospective cohort study |
topic | General practice / Family practice |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6936984/ https://www.ncbi.nlm.nih.gov/pubmed/31888923 http://dx.doi.org/10.1136/bmjopen-2019-030101 |
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