The impact of quality and accessibility of primary care on emergency admissions for a range of chronic ambulatory care sensitive conditions (ACSCs) in Scotland: longitudinal analysis

BMC Family Practice
Marjon van der PolAlastair H Leyland

Abstract

Hospital admissions for Ambulatory Care Sensitive Conditions (ACSC) are those that could potentially be prevented by timely and effective disease management within primary care. ACSC admissions are increasingly used as performance indicators. However, key questions remain about the validity of these measures. The evidence to date has been inconclusive and limited to specific conditions. The aim of this study was to test the robustness of ACSC admissions as indicators of the quality of primary care. It is the first study to examine a wide range of ACSCs using longitudinal data which enables us to control for unmeasured characteristics which differ by practice but which are constant over time. Using longitudinal data at the practice level, from 907 Scottish practices for the time period 1/4/2005 to 31/32012, we explored the relationships between the quality of primary care, and hospital admissions for multiple ACSCs controlling for a wide range of covariates including characteristics of GP practices, characteristics of the practice population, hospital effects and year effects. We examined the impact of two dimensions of quality of care: clinical quality of and access to daytime general practice. Generalised Estimating Equations ...Continue Reading

References

Dec 6, 2011·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Michael SoljakAzeem Majeed
Mar 19, 2013·International Journal for Equity in Health·Jean-Frederic LevesqueGrant Russell
Dec 19, 2013·The Journal of the Royal College of Physicians of Edinburgh·S Purdey, A Huntley

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