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Unseen patterns of preventable emergency care: Emergency department visits for ambulatory care sensitive conditions
OBJECTIVE: Admissions for ambulatory care sensitive conditions (ACSCs) are often used to measure potentially preventable emergency care. Visits to emergency departments with ACSCs may also be preventable care but are excluded from such measures if patients are not admitted. We established the extent...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9277334/ https://www.ncbi.nlm.nih.gov/pubmed/35125033 http://dx.doi.org/10.1177/13558196211059128 |
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author | Parkinson, Beth Meacock, Rachel Checkland, Katherine Sutton, Matt |
author_facet | Parkinson, Beth Meacock, Rachel Checkland, Katherine Sutton, Matt |
author_sort | Parkinson, Beth |
collection | PubMed |
description | OBJECTIVE: Admissions for ambulatory care sensitive conditions (ACSCs) are often used to measure potentially preventable emergency care. Visits to emergency departments with ACSCs may also be preventable care but are excluded from such measures if patients are not admitted. We established the extent and composition of this preventable emergency care. METHODS: We analysed 1,505,979 emergency department visits (5% of the national total) between 1 April 2015 and 31 March 2017 at six hospital Trusts in England, using International Classification of Diseases diagnostic coding. We calculated the number of visits for each ACSC and examined the proportions of these visits that did not result in admission by condition and patient characteristics. RESULTS: 11.1% of emergency department visits were for ACSCs. 55.0% of these visits did not result in hospital admission. Whilst the majority of ACSC visits were for acute rather than chronic conditions (59.4% versus 38.4%), acute visits were much more likely to conclude without admission (70.3% versus 33.4%). Younger, more deprived and ethnic minority patients were less likely to be admitted when they visited the emergency department with an ACSC. CONCLUSIONS: Over half of preventable emergency care is not captured by measures of admissions. The probability of admission at a preventable visit varies substantially between conditions and patient groups. Focussing only on admissions for ACSCs provides an incomplete and skewed picture of the types of conditions and patients receiving preventable care. Measures of preventable emergency care should include visits in addition to admissions. |
format | Online Article Text |
id | pubmed-9277334 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-92773342022-07-14 Unseen patterns of preventable emergency care: Emergency department visits for ambulatory care sensitive conditions Parkinson, Beth Meacock, Rachel Checkland, Katherine Sutton, Matt J Health Serv Res Policy Original Research OBJECTIVE: Admissions for ambulatory care sensitive conditions (ACSCs) are often used to measure potentially preventable emergency care. Visits to emergency departments with ACSCs may also be preventable care but are excluded from such measures if patients are not admitted. We established the extent and composition of this preventable emergency care. METHODS: We analysed 1,505,979 emergency department visits (5% of the national total) between 1 April 2015 and 31 March 2017 at six hospital Trusts in England, using International Classification of Diseases diagnostic coding. We calculated the number of visits for each ACSC and examined the proportions of these visits that did not result in admission by condition and patient characteristics. RESULTS: 11.1% of emergency department visits were for ACSCs. 55.0% of these visits did not result in hospital admission. Whilst the majority of ACSC visits were for acute rather than chronic conditions (59.4% versus 38.4%), acute visits were much more likely to conclude without admission (70.3% versus 33.4%). Younger, more deprived and ethnic minority patients were less likely to be admitted when they visited the emergency department with an ACSC. CONCLUSIONS: Over half of preventable emergency care is not captured by measures of admissions. The probability of admission at a preventable visit varies substantially between conditions and patient groups. Focussing only on admissions for ACSCs provides an incomplete and skewed picture of the types of conditions and patients receiving preventable care. Measures of preventable emergency care should include visits in addition to admissions. SAGE Publications 2022-02-06 2022-07 /pmc/articles/PMC9277334/ /pubmed/35125033 http://dx.doi.org/10.1177/13558196211059128 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Parkinson, Beth Meacock, Rachel Checkland, Katherine Sutton, Matt Unseen patterns of preventable emergency care: Emergency department visits for ambulatory care sensitive conditions |
title | Unseen patterns of preventable emergency care: Emergency department
visits for ambulatory care sensitive conditions |
title_full | Unseen patterns of preventable emergency care: Emergency department
visits for ambulatory care sensitive conditions |
title_fullStr | Unseen patterns of preventable emergency care: Emergency department
visits for ambulatory care sensitive conditions |
title_full_unstemmed | Unseen patterns of preventable emergency care: Emergency department
visits for ambulatory care sensitive conditions |
title_short | Unseen patterns of preventable emergency care: Emergency department
visits for ambulatory care sensitive conditions |
title_sort | unseen patterns of preventable emergency care: emergency department
visits for ambulatory care sensitive conditions |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9277334/ https://www.ncbi.nlm.nih.gov/pubmed/35125033 http://dx.doi.org/10.1177/13558196211059128 |
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