ArticleBMJ open2013
Is secondary preventive care improving? Observational study of 10-year trends in emergency admissions for conditions amenable to ambulatory care.
Article in BMJ open, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
80 citing papers in PubMed, 4 syntheses or guidelines pooled it.
- Interventions to Prevent Potentially Avoidable Hospitalizations: A Mixed Methods Systematic Review.Frontiers in public health · 2022Pooled it
- Pooled it
- Biomarkers for diagnosing serious bacterial infections in older outpatients: a systematic review.BMC geriatrics · 2019Pooled it
- Diagnostic value of symptoms and signs for identifying urinary tract infection in older adult outpatients: Systematic review and meta-analysis.The Journal of infection · 2018Pooled it
- Trial
- Assessing Treatment Fidelity within an Epilepsy Randomized Controlled Trial: Seizure First Aid Training for People with Epilepsy Who Visit Emergency Departments.Behavioural neurology · 2019Trial
- Genitourinary microbiota in older women: a persistent knowledge gap that limits clinical and research progress.Infection and immunity · 2026Review
- Article
- Article
- Association between transitional care in acute care hospitals and ambulatory care sensitive condition-related readmission.Age and ageing · 2025Observational
- Epidemiological trends and predictions of urinary tract infections in the global burden of disease study 2021.Scientific reports · 2025Article
- Observational
- Association between continuity of primary care and preventable hospitalization in adults with asthma: A cohort study.PloS one · 2025Article
- Rapid antibiotic susceptibility testing for urinary tract infections in secondary care in England: a cost-effectiveness analysis.BMJ open · 2024Article
- Strategies for older people living in care homes to prevent urinary tract infection: the StOP UTI realist synthesis.Health technology assessment (Winchester, England) · 2024Review
- Relationship between continuity of primary care and hospitalisation for patients with COPD: population-based cohort study from South Korea.BMJ open respiratory research · 2024Article
- Impact of vertical integration on patients' use of hospital services in England: an analysis of activity data.BJGP open · 2024Article
- Article
- Evaluating video and hybrid group consultations in general practice: mixed-methods, participatory study protocol (TOGETHER 2).NIHR open research · 2024Article
- Severe and common mental disorders and risk of emergency hospital admissions for ambulatory care sensitive conditions among the UK Biobank cohort.BJPsych open · 2023Article
20 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo identify trends in emergency admissions for patients with clinical conditions classed as 'ambulatory care sensitive' (ACS) and assess if reductions might be due to improvements in preventive care.
designObservational study of routinely collected hospital admission data from March 2001 to April 2011. Admission rates were calculated at the population level using national population estimates for area of residence.
participantsAll emergency admissions to National Health Service (NHS) hospitals in England from April 2001 to March 2011 for people residents in England.
main outcome measuresAge-standardised emergency admissions rates for each of 27 specific ACS conditions (ICD-10 codes recorded as primary or secondary diagnoses).
resultsBetween April 2001 and March 2011 the number of admissions for ACS conditions increased by 40%. When ACS conditions were defined solely on primary diagnosis, the increase was less at 35% and similar to the increase in emergency admissions for non-ACS conditions. Age-standardised rates of emergency admission for ACS conditions had increased by 25%, and there were notable variations by age group and by individual condition. Overall, the greatest increases were for urinary tract infection, pyelonephritis, pneumonia, gastroenteritis and chronic obstructive pulmonary disease. There were significant reductions in emergency admission rates for angina, perforated ulcers and pelvic inflammatory diseases but the scale of these successes was relatively small.
conclusionsIncreases in rates of emergency admissions suggest that efforts to improve the preventive management of certain clinical conditions have failed to reduce the demand for emergency care. Tackling the demand for hospital care needs more radical approaches than those adopted hitherto if reductions in emergency admission rates for ACS conditions overall are to be seen as a positive outcome of for NHS.
Identifiers
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.