ArticleBMJ open2019
Regional variation of avoidable hospitalisations in a universal health care system: a register-based cohort study from Finland 1996-2013.
Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Long-term care use, hospitalizations and mortality during COVID-19 in Finland and Sweden: A nationwide register-based study in 2020.Scandinavian journal of public health · 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
- Predicting Future Geographic Hotspots of Potentially Preventable Hospitalisations Using All Subset Model Selection and Repeated K-Fold Cross-Validation.International journal of environmental research and public health · 2021Article
- Avoidable Hospitalization Trends From Ambulatory Care-Sensitive Conditions in the Public Health System in México.Frontiers in public health · 2021Article
- Comparison and Impact of Four Different Methodologies for Identification of Ambulatory Care Sensitive Conditions.International journal of environmental research and public health · 2020Article
- Comparing data sources in estimating disability-adjusted life years (DALYs) for ischemic heart disease and chronic obstructive pulmonary disease in a cross-sectional setting in Finland.Archives of public health = Archives belges de sante publique · 2020Article
- Partnership between Primary Health and Social Care Services in the Long-Term Care of Older People with Dementia: A Vignette Study.Inquiry : a journal of medical care organization, provision and financingArticle
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Authors and funding
4 authors.
Funding
Abstract
objectivesA persistent finding in research concerning healthcare and hospital use in Western countries has been regional variation in the medical practices. The aim of the current study was to examine trends in the regional variation of avoidable hospitalisations, that is, hospitalisations due to conditions treatable in ambulatory care in Finland in 1996-2013 and the influence of different healthcare levels on them.
settingUse of hospital inpatient care in 1996-2013 among the total population in Finland.
participantsAltogether 1 931 012 hospital inpatient care episodes among all persons residing in Finland identified from administrative registers in Finland in 1996-2013 and alive in 1 January 1996. OUTCOME MEASURES: We examined hospitalisations due to avoidable causes including vaccine-preventable hospitalisations, hospitalisations due to complications of chronic conditions and acute conditions treatable in ambulatory care. We calculated annual age-adjusted rates per 10 000 person-years. Multilevel models were used for studying time trends in regional variation.
resultsThere was a steep decline in avoidable hospitalisation rates during the study period. The decline occurred almost exclusively in hospitalisations due to chronic conditions, which diminished by about 60%. The overall correlation between hospital district intercepts and slopes in time was -0.46 (p<0.05) among men and -0.20 (ns) among women. Statistically highly significant diminishing variation was found in hospitalisations due to chronic conditions among both men (-0.90) and women (-0.91). The variation was mainly distributed to the hospital district level.
conclusionsThe results suggest that chronic conditions are managed better in primary care in the whole country than before. Further research is needed on whether this is the case or whether this has more to do with supply of hospital care.
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