AMBULATORY CARE SENSITIVE (ACS) CONDITION HOSPITAL DISCHARGE
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Why is this important?
Ambulatory care sensitive (ACS) conditions represent medical problems like lung infections, adult asthma, high blood pressure, urinary tract infections, and diabetes for which patients were admitted to a hospital that either could have been prevented, or if treated with timely care, not necessarily have required hospitalization in the first place. In many cases, preventive care and early treatment can reduce the onset of certain illnesses, control an acute episodic occurrence of an illness, or help to manage a chronic medical condition without hospitalization. Having to hospitalize people for conditions that would not have required it if early detection and preventive treatment had been provided adds enormously to overall healthcare costs.
How are we doing?
Overall, the number of ACS hospitalizations has been relatively stable from 2000 to 20061 . ACS hospitalizations increased by 4% between 2000 and 2005. However, the 29,976 ACS admissions (as identified by the PQIs) in 2006 represented a 5% decrease from the total for 2005.
Many factors, both within and without the healthcare system, contribute to ACS-associated hospitalizations. Some of those include patients’ economic circumstances that limit their access to preventive healthcare, poor environmental conditions, limited community access to local healthcare facilities, and other factors associated with economic hardships. This is evident at the community level, as those communities with higher rates of Medicaid and uninsured hospitalizations tend to also have higher rates of ACS hospitalizations. There is a wide disparity across Long Island communities in the rates of ACS hospitalizations.
1Measuring ACS Hospitalizations: The Preventive Quality Indicators (PQIs) are measurements of the occurrences of hospitalizations for diagnoses associated with ambulatory care sensitive (ACS) conditions. The PQIs utilize inpatient hospital records to establish admissions and discharge rates for ACS conditions. Here we use twelve indicators associated with adult hospital admissions: short-term diabetes, long-term diabetes, obstructive pulmonary disease, hypertension (high blood pressure), congestive heat failure, dehydration, bacterial pneumonia, urinary infections, angina without procedure, uncontrolled diabetes, adult asthma, lower extremity amputations (associated with diabetes).