Parker J D, Schoendorf K C
Infant and Child Health Studies Branch, National Center for Health Statistics, Hyattsville, Maryland, USA.
Pediatrics. 2000 Oct;106(4 Suppl):942-8.
Ambulatory Care-Sensitive Conditions (ACSCs), conditions for which ambulatory care may reduce, though not eliminate, the need for hospital admission, have been used as an index of adequate primary care. However, few studies of ACSC have focused on children. We estimated national hospitalization rates for ACSC among children and examined the behavior of the index between subgroups of children.
We used data from the 1990-1995 National Hospital Discharge Surveys (NHDS), the US census, and the National Health Interview Survey (NHIS) to calculate hospital discharge rates. Rates were estimated as the number of condition-specific hospital discharges from the NHDS divided by the population at risk, as estimated from the US census and NHIS.
Predictably, ACSC hospitalization rates were significantly higher among children who were younger, black, had Medicaid insurance, and lived in poorer areas compared with their counterparts. However, the relationship between ACSCs and income and the distributions of conditions within the index varied significantly between children.
ACSCs may indicate disparities in access and utilization of health care, however, the differing behavior of the index between subgroups suggests that inferences from examining rates of ACSCs may not be comparable for all children.ambulatory care-sensitive conditions, hospitalization rates.
门诊医疗敏感疾病（ACSCs），即那些门诊医疗虽不能消除但可减少住院需求的疾病，已被用作初级保健是否充分的一个指标。然而，很少有关于ACSCs的研究聚焦于儿童。我们估算了全国儿童ACSCs的住院率，并研究了该指标在不同儿童亚组中的表现。
我们使用了1990 - 1995年全国医院出院调查（NHDS）、美国人口普查以及国家健康访谈调查（NHIS）的数据来计算医院出院率。住院率的估算方法是，将NHDS中特定疾病的医院出院人数除以根据美国人口普查和NHIS估算的有风险人群数量。
不出所料，与同龄人相比，年龄较小、为黑人、有医疗补助保险且生活在贫困地区的儿童ACSCs住院率显著更高。然而，ACSCs与收入之间的关系以及该指标内疾病的分布在不同儿童之间差异显著。
ACSCs可能表明在医疗保健的可及性和利用方面存在差异，然而，该指标在不同亚组间的不同表现表明，通过检查ACSCs发生率得出的推断可能并非对所有儿童都具有可比性。门诊医疗敏感疾病，住院率。
