Jianchao Quan (
Huyang Zhang is a PhD student in the China Center for Health Development Studies at Peking University, Beijing, in China.
Health Aff (Millwood). 2017 Nov;36(11):1896-1903. doi: 10.1377/hlthaff.2017.0479.
Improving the quality of primary care may reduce avoidable hospital admissions. Avoidable admissions for conditions such as diabetes are used as a quality metric in the Health Care Quality Indicators of the Organization for Economic Cooperation and Development (OECD). Using the OECD indicators, we compared avoidable admission rates and spending for diabetes-related complications in Japan, Singapore, Hong Kong, and rural and peri-urban Beijing, China, in the period 2008-14. We found that spending on diabetes-related avoidable hospital admissions was substantial and increased from 2006 to 2014. Annual medical expenditures for people with an avoidable admission were six to twenty times those for people without an avoidable admission. In all of our study sites, when we controlled for severity, we found that people with more outpatient visits in a given year were less likely to experience an avoidable admission in the following year, which implies that primary care management of diabetes has the potential to improve quality and achieve cost savings. Effective policies to reduce avoidable admissions merit investigation.
改善初级保健质量可能会降低可避免的住院率。在经济合作与发展组织（OECD）的医疗质量指标中，糖尿病等疾病的可避免住院率被用作质量指标。利用经合组织的指标，我们比较了 2008-14 年期间日本、新加坡、中国香港以及中国北京农村和城乡结合部的可避免糖尿病住院率和相关费用。我们发现，与糖尿病相关的可避免住院的费用很高，并且从 2006 年到 2014 年一直在增加。可避免住院的患者的年医疗支出是无可避免住院的患者的六到二十倍。在我们所有的研究地点，当我们控制严重程度时，我们发现，在给定的一年中门诊就诊次数越多的人，下一年发生可避免住院的可能性越低，这意味着糖尿病的初级保健管理有可能提高质量并节省成本。值得研究减少可避免住院的有效政策。
