Finnish Cancer Registry, Helsinki, Finland.
Service System Research, Finnish Institute for Health and Welfare, Helsinki, Finland.
Scand J Public Health. 2020 Dec;48(8):839-846. doi: 10.1177/1403494820944722. Epub 2020 Aug 5.
Hospitalisations for ambulatory care sensitive conditions are used as an outcome indicator of access to and quality of primary care. Evidence on mortality related to these hospitalisations is scarce. This study analysed the effect of ambulatory care sensitive condition hospitalisations to subsequent mortality and time or geographical trends in the mortality indicating variations in ambulatory care sensitive conditions outcomes. This retrospective cohort study used individual-level data from national registers concerning ambulatory care sensitive condition hospitalisations. Crude and age-adjusted 365-day mortality rates for the first ambulatory care sensitive condition-related admission were calculated for vaccine-preventable, acute, and chronic ambulatory care sensitive conditions separately, and for three time periods stratified by gender. The mortality rates were also compared to mortality in the general Finnish population to assess the excess mortality related to ambulatory care sensitive condition hospitalisations. The data comprised a total of 712,904 ambulatory care sensitive condition hospital admissions with the crude 365-day mortality rate of 14.2 per 100 person-years. Mortality for those hospitalised for vaccine-preventable conditions was approximately 10-fold compared to the general population and four-fold in chronic and acute conditions. Of the 10 most common ambulatory care sensitive conditions, bacterial pneumonia and influenza and congestive heart failure were associated with highest age-standardised mortality rates.
门诊医疗敏感条件住院率被用作评估初级保健可及性和质量的结果指标。关于这些住院与死亡率相关的证据很少。本研究分析了门诊医疗敏感条件住院对随后死亡率的影响，以及死亡率的时间或地理趋势，表明门诊医疗敏感条件结果存在差异。本回顾性队列研究使用了国家登记处关于门诊医疗敏感条件住院的个人水平数据。分别计算了疫苗可预防、急性和慢性门诊医疗敏感条件相关首次住院的粗死亡率和年龄调整后 365 天死亡率，并按性别分为三个时间段分层。还将死亡率与芬兰普通人群的死亡率进行了比较，以评估与门诊医疗敏感条件住院相关的超额死亡率。数据共包括 712904 例门诊医疗敏感条件住院，粗 365 天死亡率为每 100 人年 14.2 例。因疫苗可预防疾病住院的患者的死亡率与普通人群相比约为 10 倍，慢性和急性疾病的死亡率为 4 倍。在最常见的 10 种门诊医疗敏感条件中，细菌性肺炎和流感以及充血性心力衰竭与最高的年龄标准化死亡率相关。
