Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Aug 4;16(a):348.
doi: 10.1186/s12913-016-1584-2.

The impact of multiple chronic diseases on hospitalizations for ambulatory care sensitive conditions

Inês Dantas  1 , Rui Santana  2   3 , João Sarmento  4 , Pedro Aguiar  3   5
Affiliations

The impact of multiple chronic diseases on hospitalizations for ambulatory care sensitive conditions

Inês Dantas et al. BMC Health Serv Res. .

Abstract

Background: The high financial burden of avoidable hospitalizations has led to an increase of the study of hospitalizations for ambulatory care sensitive conditions (ACSC). There is limited information on the impact of secondary diagnoses on these hospitalizations, although patients' social and demographic characteristics, as well as the coexistence of multiple diseases are often identified in the literature as risk factors for avoidable hospitalizations. This study explores the impact of chronic conditions on the likelihood of hospitalizations for ACSC.

Methods: Data were extracted from the Portuguese hospital discharge database. Avoidable hospitalizations were identified according to the Canadian Institute for Healthcare Information, and chronic conditions were identified according to criteria set by the Agency for Healthcare Research and Quality. A retrospective study analysing all patients hospitalized for an ACSC and all patients hospitalized for non-ACSC was made, using multiple logistic regression models to identify the impact of chronic conditions on the risk of admission.

Results: The risk of an avoidable hospitalization increases by a factor of 1.35 (95 % CI [1.34;1.35]) for each additional chronic condition, and 1.55 (95 % CI [1.55;1.56]) for each additional body system affected. The respiratory and circulatory systems have the most impact on the risk of ACSC, increasing the risk by 8.72 (95 % CI [8.58;8.86]) and 3.01 (95 % CI [2.95;3.06]), respectively.

Conclusions: The number of chronic conditions and the body systems affected increase the risk of hospital admissions for ACSC.

Keywords: Ambulatory care sensitive conditions; Avoidable hospitalizations; Chronic conditions.

PubMed Disclaimer

References

    1. Caminal J, Starfield B, Sánchez E, et al. The role of primary care in preventing ambulatory care sensitive conditions. Eur J Public Health. 2004;14(3):246–51. doi: 10.1093/eurpub/14.3.246. - DOI - PubMed
    1. Agency for Healthcare Research and Quality. Prevention quality indicators [Internet]. Rockville: Agency for Healthcare Research and Quality; 2010 [cited 2016 Apr 08]. Available at: http://www.qualityindicators.ahrq.gov/Downloads/Modules/PQI/V42/PQI_Broc...
    1. Walker R, Chen G, McAlister F, et al. Hospitalization for uncomplicated hypertension : an ambulatory care sensitive condition. Can J Cardiol. 2013;29(11):1462–9. doi: 10.1016/j.cjca.2013.05.002. - DOI - PubMed
    1. Ansari Z, Haider S, Ansari H, et al. Patient characteristics associated with hospitalisations for ambulatory care sensitive conditions in Victoria, Australia. BMC Health Serv Res. 2012;12(1):475. doi: 10.1186/1472-6963-12-475. - DOI - PMC - PubMed
    1. Giuffrida A, Gravelle H, Roland M. Measuring quality of care with routine data : avoiding confusion between performance indicators and health outcomes. Br Med J. 1999;319(July):94–8. doi: 10.1136/bmj.319.7202.94. - DOI - PMC - PubMed