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Medical Care Research and Review, Vol. 63, No. 6, 719-741 (2006)
DOI: 10.1177/1077558706293637

Access to Health Care and Hospitalization for Ambulatory Care Sensitive Conditions

Zahid Ansari

Victorian State Government, Department of Human Services, Australia

James N. Laditka

University of South Carolina

Sarah B. Laditka

University of South Carolina

Hospitalization for Ambulatory Care Sensitive Conditions (ACSH) is an accepted indicator of access to health care and avoidable morbidity. Accessible care of reasonable quality should reduce ACSH. Little research has examined the indicator’s external validity. We calculated standardized ACSH rates for 32 areas of Victoria, Australia (population 4.4 million). A representative survey measured access, disease prevalence, propensity to seek care, disease burden, social determinants of health services use, and behavioral risk factors. Regression analyses compared self-rated access with ACSH rates. Independent of prevalence, propensity to seek care, disease burden, and physician supply, better access was associated with lower ACSH rates. Results provide support for the ACSH indicator. When rural residence was considered, the covariate measuring access was not significant. However, rural residence also may contribute importantly to access. Results suggest both the complexity of the meaning of access and the desirability of further research to validate the ACSH indicator.

Key Words: ambulatory care sensitive conditions • preventable hospitalization • access to medical care • primary health care • physician supply

References

  • Agency for Healthcare Research and Quality (AHRQ). 2001. Technical review number 4: Refinement of the HCUP quality indicators. AHRQ Publication No. 01-0035. Prepared by the University of Southern California-Stanford Evidence-based Practice Center. Rockville, MD: U.S. Department of Health and Human Services.
  • Alazri, M. H., and R. D. Neal. 2003. The association between satisfaction with services provided in primary care and outcomes in Type 2 diabetes mellitus. Diabetic Medicine 20(6): 486-490.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Almirall, J., I. Bolibar, X. Balanzo, and C. A. Gonzalez. 1999. Risk factors for community-acquired pneumonia in adults: A population-based case-control study. The European Respiratory Journal. 13(2): 349-355.[Medline] [Order article via Infotrieve]
  • Ansari, M. Z., T. Barbetti, N. J. Carson, M. J. Auckland, and F. Cicuttini. 2003. The Victorian ambulatory care sensitive conditions study: Rural and urban perspectives. Sozial-und Praventivmedizin 48(1): 33-43.
  • Ansari, M. Z., T. Henderson, M. Ackland, F. Cicuttini, and V. Sundararajan. 2003. Congestive cardiac failure: Urban and rural perspectives in Victoria. Australian Journal of Rural Health 11(6): 266-270.[Medline] [Order article via Infotrieve]
  • Ansari, Z., N. Carson, A. Serraglio, T. Barbetti, and F. Cicuttini. 2002. The Victorian ambulatory care sensitive conditions study: Reducing demand on hospital services in Victoria. Australian Health Review 25(2): 71-77.[Medline] [Order article via Infotrieve]
  • Ansari, Z., M. M. Haby, T. Henderson, F. Cicuttini, and M. J. Ackland. 2003. Trends and geographic variations in hospital admissions for asthma in Victoria: Opportunities for targeted interventions. Australian Family Physician 32(4): 286-288.[Medline] [Order article via Infotrieve]
  • Basu, J., B. Friedman, and H. Burstin. 2002. Primary care, HMO enrollment, and hospitalization for ambulatory care sensitive conditions: A new approach. Medical Care 40(12): 1260-1269.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Billings, J., T. Mijanovich, and A. Blank. 1997. Barriers to care for patients with preventable hospital admissions. New York: United Hospital Fund.
  • Billings, J., L. Zeitel, J. Lukomnik, T. S. Carey, A. E. Blank, and L. Newman. 1993. Impact of socioeconomic status on hospital resource use in New York City. Health Affairs 12(1): 162-173.[Abstract]
  • Bindman, A. B., A. Chattopadhyay, D. H. Osmond, W. Huen, and P. Bacchetti. 2005. The impact of Medicaid managed care on hospitalizations for ambulatory care sensitive conditions. Health Services Research 40(1): 19-37.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Bindman, A. B., K. Grumbach, D. Osmond, M. Komaromy, K. Vranizan, N. Lurie, J. Billings, and A. Stewart. 1995. Preventable hospitalization and access to health care. Journal of the American Medical Association 274(4): 305-311.[Abstract]
  • Brown A. D., M. J. Goldacre, N. Hicks, J. T. Rourke, R. Y. McMurtry, J. D. Brown, and G. M. Anderson. 2001. Hospitalization for ambulatory care-sensitive conditions: A method for comparative access and quality studies using routinely collected statistics. Canadian Journal of Public Health 92(2): 155-159.[ISI][Medline] [Order article via Infotrieve]
  • Cockley, D. E. 1996. The effect of subsidized primary care centers on avoidable hospitalization in West Virginia communities during 1988-1992. Chapel Hill, NC: University of North Carolina at Chapel Hill.
  • Culler, S. D., M. L. Parchman, and M. Przybylski. 1998. Factors related to potentially preventable hospitalizations among the elderly. Medical Care 36(6): 804-817.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • DeLia, D. 2003. Distributional issues in the analysis of preventable hospitalizations. Health Services Research 38 (6 pt. 2): 1761-1779.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Deyo, R. A., D. C. Cherkin, and M. A. Ciol. 1992. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. Journal of Clinical Epidemiology 45: 613-619.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group. 2005. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. The New England Journal of Medicine 353(25): 2643-2653.[Abstract/Free Full Text]
  • Division of Health Care Finance and Policy, State of Massachusetts. 1995. Improving primary care: Using preventable hospitalization as an approach. Boston, MA: Division of Health Care Finance and Policy.
  • Fitzpatrick, A. L., N. R. Powe, L. S. Cooper, D. G. Ives, and J. A. Robbins. 2004. Barriers to health care access among the elderly and who perceives them. American Journal of Public Health 94(10): 1788-1794.[Abstract/Free Full Text]
  • Foland, J. 2000. Avoidable hospitalizations: An indicator of inadequate primary care. Issue Brief #2000-1. Division of Policy, Planning, and Analysis, Connecticut Department of Public Health.
  • Folland, S., A. C. Goodman, and M. Stano. 1997. The economics of health care. 2d ed. Upper Saddle River, NJ: Prentice Hall.
  • Gary, T. L., E. M. Maiese, M. Batts-Turner, N. Y. Wang, and F. L. Brancati. 2005. Patient satisfaction, preventive services, and emergency room use among African-Americans with type 2 diabetes. Disease Management 8(6): 361-371.[Medline] [Order article via Infotrieve]
  • Gulliford, M. C. 2002. Availability of primary care doctors and population health in England: Is there an association? Journal of Public Health Medicine 24: 252-254.[Abstract/Free Full Text]
  • Hughes, S. L., F. M. Weaver, A. Giobbie-Hurder, L. Manheim, W. Henderson, J. D. Kubal, A. Ulasevich, and J. Cummings. 2000. Department of Veterans Affairs cooperative study group on home-based primary care. Effectiveness of team-managed home-based primary care: A randomized multicenter trial. Journal of the American Medical Association 284 (22): 2877-2885.[Abstract/Free Full Text]
  • Hugo, G. J., E. Bamford, and L. Dunne. 1999. Accessibility remoteness index of Australia (ARIA). Department of Health and Aged Care Occasional Papers Series No. 6. Canberra: Commonwealth Department of Health and Aged Care.
  • Institute of Medicine. 1993. Access to health care in America. Edited by M. Millman. Washington, DC: National Academy Press.
  • Jones-Vessey, K. 1999. Potentially avoidable hospitalizations in North Carolina, 1997. SCHS Studies no. 118, North Carolina Public Health. Raleigh, NC: State Center for Health Statistics.
  • Klatsky, A. L., D. Chartier, N. Udaltsova, S. Gronningen, S. Brar, G. D. Friedman, and R. J. Lundstrom. 2005. Alcohol drinking and risk of hospitalization for heart failure with and without associated coronary artery disease. American Journal of Cardiology 96(3): 346-351.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Komaromy, M., N. Lurie, D. Osmond, K. Vranizan, D. Keane, and A. B. Bindman. 1996. Physician practice style and rates of hospitalization for chronic medical conditions. Medical Care 34(6): 594-609.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Krakauer, H., I. Jacoby, M. Millman, and J. E. Lukomnik. 1996. Physician impact on hospital admission and on mortality rates in the Medicare population. Health Services Research 31(2): 191-211.[ISI][Medline] [Order article via Infotrieve]
  • Kreuter, M. W., S. G. Chheda, and F. C. Bull. 2000. How does physician advice influence patient behavior? Evidence for a priming effect. Archives of Family Medicine 9(5): 426-433.[Abstract/Free Full Text]
  • LaCroix, A. Z., S. G. Leveille, J. A. Hecht, L. C. Grothaus, and E. H. Wagner. 1996. Does walking decrease the risk of cardiovascular disease hospitalizations and death in older adults? Journal of the American Geriatrics Society 44(2): 113-120.[ISI][Medline] [Order article via Infotrieve]
  • Laditka, J. N. 2003. Hazards of hospitalization for ambulatory care sensitive conditions among older women: Evidence of greater risks for African Americans and Hispanics. Medical Care Research and Review 60(4): 468-495.[Abstract/Free Full Text]
  • Laditka, J. N. 2004. Physician supply, physician diversity, and outcomes of primary health care for older persons in the United States. Health and Place 10: 231-244.
  • Laditka, J. N., and S. B. Laditka. 2004. Insurance status and primary care access: Disparate outcomes for preventable hospitalization. Journal of Health and Social Policy 19(2): 81-100.[CrossRef]
  • Laditka, J. N., and S. B. Laditka. 2006. Race, ethnicity, and hospitalization for six chronic ambulatory care sensitive conditions in the United States. Ethnicity and Health 11(3): 247-263.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Laditka, J. N., S. B. Laditka, and M. P. Mastanduno. 2003. Hospital utilization for ambulatory care sensitive conditions: Health outcome disparities associated with race and ethnicity. Social Science and Medicine 57: 1429-1441.[CrossRef][Medline] [Order article via Infotrieve]
  • Laditka, J. N., S. B. Laditka, and J. Probst. 2005. More may be better: Evidence that a greater supply of primary care physicians reduces hospitalization for ambulatory care sensitive conditions. Health Services Research 40(4): 1148-1166.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Laditka, S. B., and J. M. Johnston. 1999. Preventable hospitalization and avoidable maternity outcomes: Implications for access to health services for Medicaid recipients. Journal of Health and Social Policy 11(2): 41-56.[CrossRef]
  • Laditka, S. B., and J. N. Laditka. 1999. Geographic variation in preventable hospitalization of older women and men: Implications for access to primary health care. Journal of Women and Aging 11(4): 43-56.
  • Lemon, C. C., K. Lacey, B. Lohse, D. O. Hubacher, B. Klawitter, and M. Palta. 2004. Outcomes monitoring of health, behavior, and quality of life after nutrition intervention in adults with type 2 diabetes. Journal of the American Dietetic Association 104(12): 1805-1815.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • Lerman, I. 2005. Adherence to treatment: The key for avoiding long-term complications of diabetes. Archives of Medical Research 36(3): 300-306.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • McCall, N. T. 2004. Investigation of increasing rates of hospitalization for ambulatory care sensitive conditions among Medicare fee-for-service beneficiaries, final report. RTI Project Number 08686.001.002. Washington, DC: RTI International.
  • Millar, E. A. 2005. State health policy making determinants, theory, and methods: A synthesis. Social Science and Medicine 61(12): 2639-2657.[CrossRef][Medline] [Order article via Infotrieve]
  • Naylor, M. D., D. Brooten, R. Campbell, B. S. Jacobsen, M. D. Mezey, M. V. Pauly, and J. S. Schwartz. 1999. Comprehensive discharge planning and home follow-up of hospitalized elders: A randomized clinical trial. Journal of the American Medical Association 281(7): 613-620.[Abstract/Free Full Text]
  • Naylor, M. D., D. A. Brooten, R. L. Campbell, G. Maislin, K. M. McCauley, and J. S. Schwartz. 2004. Transitional care of older adults hospitalized with heart failure: A randomized, controlled trial. Journal of the American Geriatrics Society 52(5): 675-684.[CrossRef][ISI][Medline] [Order article via Infotrieve]
  • New Hampshire Department of Health and Human Services, Office of Planning and Research. 2001. New Hampshire regional health profiles: Healthy New Hampshire 2010. Concord, NH: New Hampshire Department of Health and Human Services.
  • Oddone, E. Z., M. Weinberger, A. Giobbie-Hurder, P. Landsman, and W. Henderson. 1999. Enhanced access to primary care for patients with congestive heart failure: Veterans Affairs cooperative study group on primary care and hospital readmission. Effective Clinical Practice 2(5): 201-209.[Medline] [Order article via Infotrieve]
  • Pappas, G., W. C. Hadden, L. J. Kozak, and G. F. Fisher. 1997. Potentially avoidable hospitalizations: Inequalities in rates between US socioeconomic groups. American Journal of Public Health 87(5): 811-816.[Abstract/Free Full Text]
  • Parchman, L., and S. Culler. 1994. Primary care physicians and avoidable hospitalizations. Journal of Family Practice 39(2): 123-129.[ISI][Medline] [Order article via Infotrieve]
  • Primary and Community Health Branch. 2004. Primary Care Partnerships strategic directions 2004-2006. Melbourne, Victoria: Victorian Government, Department of Human Services.
  • Rich, M. W., V. Beckham, C. Wittenberg, C. L. Leven, K. E. Freedland, and R. M. Carney. 1995. A multidisciplinary intervention to prevent the readmission of elderly patients with congestive heart failure. New England Journal of Medicine 333(18): 1190-1195.[Abstract/Free Full Text]
  • Ricketts, T. C., R. Randoph, H. A. Howard, D. Pathman, and T. Carey. 2001. Hospitalization rates as indicators of access to primary care. Health and Place 7: 27-38.
  • Schoen, C., R. Osborn, P. T. Huynh, M. Doty, K. Davis, K. Zapert, and J. Peugh. 2004. Primary care and health system performance: Adults’ experiences in five countries. Health Affairs. Web publication while in press, W4-487 - W4-583. Accessed June 29, 2005, from http://content.healthaffairs.org/cgi/reprint/hlthaff.w4.487v1.
  • Schreiber, S., and T. Zielinski. 1997. The meaning of ambulatory care sensitive admissions: Urban and rural perspectives. Journal of Rural Health 13(4): 276-284.[ISI][Medline] [Order article via Infotrieve]
  • Shukla, R. K., and J. P. Pestian. 1996. Small area analysis of primary care sentinel events in Virginia. Richmond, VA: Virginia Commonwealth, Williamson Institute for Health Studies.
  • Silver, M. P., M. E. Babitz, and M. K. Magill. 1997. Ambulatory care sensitive hospitalization rates in the aged Medicare population in Utah, 1990 to 1994: A rural-urban comparison. Journal of Rural Health 13(4): 285-294.[ISI][Medline] [Order article via Infotrieve]
  • Weissman, J. S., C. Gatsonis, and A. M. Epstein. 1992. Rates of avoidable hospitalization by insurance status in Massachusetts and Maryland. Journal of the American Medical Association 268(17): 2388-2394.[Abstract]
  • Worcester, M. U., Z. Stojcevski, B. Murphy, and A. J. Goble. 2003. Long-term behavioral outcomes after attendance at a secondary prevention clinic for cardiac patients. Journal of Cardiopulmonary Rehabilitation 23(6): 415-422.[CrossRef][Medline] [Order article via Infotrieve]

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