ArticleBMC health services research2008
Geographic variations in avoidable hospitalizations in the elderly, in a health system with universal coverage.
Article in BMC health services research, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
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Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of the magnitude and cause of geographic variation in unplanned hospital admission rates and length of stay for ambulatory care sensitive conditions.BMC health services research · 2015Pooled it
- International comparison of equity gradients in hospitalizations for ambulatory care sensitive conditions.BMC health services research · 2026Article
- The Influence of the COVID-19 Pandemic on Hospitalizations for Ambulatory Care-Sensitive Conditions in Split-Dalmatia County, Croatia.Medicina (Kaunas, Lithuania) · 2024Article
- Performing up to Nordic principles? Geographic and socioeconomic equity in ambulatory care sensitive conditions among older adults in capital areas of Denmark, Finland and Sweden in 2000-2015.BMC health services research · 2023Article
- Understanding geographical variations in health system performance: a population-based study on preventable childhood hospitalisations.BMJ open · 2022Observational
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- Defining ambulatory care sensitive conditions for adults in Portugal.BMC health services research · 2020Article
- Geographic variation in preventable hospitalisations across Canada: a cross-sectional study.BMJ open · 2020Article
- Relationship between life satisfaction and preventable hospitalisations: a population-based cohort study in Ontario, Canada.BMJ open · 2020Article
- Financial Burdens and Barriers to Care Among Nonelderly Adults With Heart Disease: 2010-2015.Journal of the American Heart Association · 2019Article
- Article
- A spatial analysis of geographic variation and factors associated with hospitalization for bacterial pneumonia in Korea.BMC pulmonary medicine · 2019Article
- Avoidable hospitalizations in Brazil and Portugal: Identifying and comparing critical areas through spatial analysis.PloS one · 2019Article
- [Primary health care strategy and its impact on avoidable hospitalizations for ambulatory care-sensitive conditions, Paraguay, 2000-2017Estratégia de atenção primária à saúde e seu impacto nas internações hospitalares evitáveis por causas sensíveis à atenção ambulatorial, Paraguai, 2000-2017].Revista panamericana de salud publica = Pan American journal of public health · 2019Article
- Observational
- Clinical characteristics and preventable acute care spending among a high cost inpatient population.BMC health services research · 2016Observational
- Rates of admission for ambulatory care sensitive conditions in France in 2009-2010: trends, geographic variation, costs, and an international comparison.The European journal of health economics : HEPAC : health economics in prevention and care · 2016Article
- [Analysis of the influence of the process of care in primary health care on avoidable hospitalizations for heart failure].Atencion primaria · 2016Article
- Quantifying Geographic Variation in Health Care Outcomes in the United States before and after Risk-Adjustment.PloS one · 2016Article
- Observational
Corrections and comments
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Authors and funding
4 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe study of Hospitalizations for ambulatory care sensitive conditions (ACSH) has been proposed as an indirect measure of access to and receipt of care by older persons at the entryway to the Spanish public health system. The aim of this work is to identify the rates of ACSH in persons 65 years or older living in different small-areas of the Community of Madrid (CM) and to detect possible differences in ACSH.
methodsCross-sectional, ecologic study, which covered all 34 health districts of the CM. The study population consisted of all individuals aged 65 years or older residing in the CM between 2001 and 2003, inclusive. Using hospital discharge data, avoidable ACSH were selected from the list of conditions validated for Spain. Age- and sex-adjusted ACSH rates were calculated for the population of each health district and the statistics describing the data variability. Point graphs and maps were designed to represent the ACSH rates in the different health districts.
resultsOf all the hospitalizations, 16.5% (64,409) were ACSH. Globally, the rate was higher among men: 33.15 per 1,000 populations vs. 22.10 in women and these differences were statistically significant (p < 0.05) in each district. For men the range was 70.82 and the coefficient of variation (CV) was 0.47, while for women the range was 43.69 and the CV was 0.48. In 93.1% of cases, the ACSH were caused by hypertensive cardiovascular disease, heart failure or pneumonia. A centripetal pattern can be observed, with lower rates in the districts in the center of the CM. This geographic distribution is maintained after grouping by sex.
conclusionA significant variation is demonstrated in "preventable" hospitalizations between the different districts. In all the districts the men present rates significantly higher than women. Important variations in the access are observed the Primary Attention in spite of existing a universal sanitary cover.
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