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
. 2022 Jul 4;22(1):856.
doi: 10.1186/s12913-022-08275-w.

Trends in avoidable hospitalizations in a developed City in eastern China: 2015 to 2018

Siyuan Chen  1 , Hongqiao Fu  2 , Weiyan Jian  3
Affiliations

Trends in avoidable hospitalizations in a developed City in eastern China: 2015 to 2018

Siyuan Chen et al. BMC Health Serv Res. .

Abstract

Objective: This study aimed to measure the avoidable hospitalization rate and the treatment cost per hospitalization in large cities of eastern China.

Methods: In this study, the hospital discharge data of all inpatients in the city from 2015 to 2018 were collected. In accordance with the organization for Economic Cooperation and Development (OECD) definition of avoidable hospitalizations, five diseases were selected as the measurement objects, including hypertension, diabetes, asthma, chronic obstructive pulmonary disease (COPD), as well as congestive heart failure (CHF). We described the avoidable hospitalization rate, average cost and length of stay for avoidable hospitalization cases. Linear probability model and log-linear model were used to control the basic characteristics and disease severity of patients, and to measure the trend of the avoidable hospitalization rate and expenditure of avoidable hospitalizations.

Results: From 2015 to 2018, the absolute number of avoidable hospitalizations in the city increased while fluctuating, which reached 125,372 in 2018. Among the five avoidable hospitalizations, the number of hospitalizations for diabetes increased continuously in the 4-year period. Congestive heart failure showed the most significant increase over the four years. Avoidable hospitalizations in the city have remained at a high level, while avoidable hospitalizations of hypertension and asthma fell to levels lower than those in 2015 in 2017 and 2018 after rising in 2016. The cost per hospitalization and length of stay per hospitalization decreased.

Conclusions: Avoidable hospitalizations in the city remain at a high level, and more effective policies should be formulated to guide patients with avoidable hospitalizations, so as to more effectively exploit outpatient services and continuously improve the quality of primary health care services.

Keywords: Avoidable hospitalization; Healthcare expenditure; Length of stay; Primary health care; Quality of care.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. Harrison MJ, Dusheiko M, Sutton M, Gravelle H, Doran T, Roland M. Effect of a national primary care pay for performance scheme on emergency hospital admissions for ambulatory care sensitive conditions: controlled longitudinal study. Bmj. 2014;349:g6423. doi: 10.1136/bmj.g6423. - DOI - PMC - PubMed
    1. Kao YH, Lin WT, Chen WH, Wu SC, Tseng TS. Continuity of outpatient care and avoidable hospitalization: a systematic review. Am J Manag Care. 2019;25(4):e126–e134. - PubMed
    1. Ansari Z. The concept and usefulness of ambulatory care sensitive conditions as indicators of quality and access to primary health care. Aust J Prim Health. 2007;13(3):91–110. doi: 10.1071/PY07043. - DOI
    1. Purdy S, Griffin T, Salisbury C, Sharp D. Ambulatory care sensitive conditions: terminology and disease coding need to be more specific to aid policy makers and clinicians. Public Health. 2009;123(2):169–173. doi: 10.1016/j.puhe.2008.11.001. - DOI - PubMed
    1. Seringa J, Marques AP, Moita B, Gaspar C, Raposo JF, Santana R. The impact of diabetes on multiple avoidable admissions: a cross-sectional study. BMC Health Serv Res. 2019;19(1):1002. doi: 10.1186/s12913-019-4840-4. - DOI - PMC - PubMed