Department of Community Medicine, Information and Health Decision Sciences (MEDCIDS), Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal.
CINTESIS-Center for Health Technology and Services Research, 4200-450 Porto, Portugal.
Int J Environ Res Public Health. 2020 Nov 3;17(21):8121. doi: 10.3390/ijerph17218121.
Ambulatory care sensitive conditions (ACSCs) are conditions for which hospitalizations are thought to be avoidable if effective and accessible primary health care is available. However, to define which conditions are considered ACSCs, there is a considerable number of different lists. Our aim was to compare the impact of using different ACSC lists considering mainland Portugal hospitalizations. A retrospective study with inpatient data from Portuguese public hospital discharges between 2011 and 2015 was conducted. Four ACSC list sources were considered: Agency for Healthcare Research and Quality (AHRQ), Canadian Institute for Health Information (CIHI), the Victorian Ambulatory Care Sensitive Conditions study, and Sarmento et al. Age-sex-adjusted rates of ACSCs were calculated by district (hospitalizations per 100,000 inhabitants). Spearman's rho, the intraclass correlation coefficient (ICC), the information-based measure of disagreement (IBMD), and Bland and Altman plots were computed. Results showed that by applying the four lists, different age-sex-adjusted rates are obtained. However, the lists that seemed to demonstrate greater agreement and consistency were the list proposed by Sarmento et al. compared to AHRQ and the AHRQ method compared to the Victorian list. It is important to state that we should compare comparable indicators and ACSC lists cannot be used interchangeably.
门诊治疗敏感条件 (ACSCs) 是指如果有有效的和可及的初级卫生保健，就可以避免住院的疾病。然而，为了确定哪些疾病被认为是 ACSC，需要考虑相当多的不同列表。我们的目的是比较使用不同的 ACSC 列表来考虑葡萄牙大陆住院治疗的影响。这是一项回顾性研究，使用了 2011 年至 2015 年葡萄牙公立医院出院的住院数据。共考虑了 4 种 ACSC 列表来源：医疗保健研究和质量局 (AHRQ)、加拿大卫生信息研究所 (CIHI)、维多利亚州门诊治疗敏感条件研究和 Sarmento 等人的研究。通过地区（每 10 万人的住院人数）计算 ACSC 的年龄性别调整率。计算了 Spearman's rho、组内相关系数 (ICC)、基于信息的不一致性测量 (IBMD) 和 Bland 和 Altman 图。结果表明，通过应用这四个列表，可以获得不同的年龄性别调整率。然而，似乎表现出更大一致性和稳定性的列表是 Sarmento 等人提出的列表，与 AHRQ 相比，AHRQ 方法与维多利亚列表相比。需要指出的是，我们应该比较可比指标，并且不能互换使用 ACSC 列表。
