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Hospitalizations for ambulatory care sensitive conditions as an indicator of access to primary care and excess of bed supply

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Authors
Kim, Agnus M; Park, Jong Heon; Yoon, Tae Ho; Kim, Yoon
Issue Date
2019-04-27
Publisher
BioMed Central
Citation
BMC Health Services Research. 19(1):259
Keywords
Ambulatory care sensitive conditionACSCHospitalizationGeographic variationBedsPrimary careKoreaSocioeconomic factors
Abstract
Background
Ambulatory care sensitive conditions (ACSC) hospitalization is a widely accepted measure of the access to primary care. However, given its discretionary characteristics, the ACSC hospitalization can be a measure reflecting the influence of hospital bed supply. In Korea, where the quality of primary care and oversupply of hospital beds are coexistent concerns, ACSC hospitalization can be used to examine the impact of both factors. This study was performed to investigate the ACSC hospitalization rate as a measure of the hospital bed supply as well as access to primary care.


Methods
Data were obtained from the National Health Insurance Database for 2015. We calculated the age-sex standardized hospitalization rates for ACSC in the total population and crude rates of ACSC hospitalization for three different age groups in 252 districts in Korea. We calculated the variation statistics of ACSC hospitalization rates, and we estimated a linear regression model to investigate the factors for ACSC hospitalization.


Results
There was a very high geographic variation in ACSC hospitalization rates. Higher density of primary care physicians was associated with a decreased ACSC hospitalization rate while a higher density of hospital beds in small to medium sized hospitals was associated with an increased rate. The deprivation index score had a strongly positive association with the ACSC hospitalization rates.


Conclusion
ACSC hospitalization, while being a negative index of primary care access, can also be a measure indicating the impact of the hospital bed supply, and it is still a valid measure of the disparity of health care, the original motivation for this topic.
ISSN
1472-6963
Language
Korean
URI
http://hdl.handle.net/10371/153820
DOI
https://doi.org/10.1186/s12913-019-4098-x
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College of Medicine/School of Medicine (의과대학/대학원)Health Policy and Management (의료관리학전공)Journal Papers (저널논문_의료관리학전공)
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