Castro Vargas Sofia, Bauhoff Sebastian
Health, Nutrition and Population Division Inter-American Development Bank Washington, D.C. USA Health, Nutrition and Population Division, Inter-American Development Bank, Washington, D.C., USA.
Rev Panam Salud Publica. 2025 Jul 21;49:e75. doi: 10.26633/RPSP.2025.75. eCollection 2025.
Ambulatory care-sensitive conditions are those for which effective primary health care services could prevent hospitalizations or mitigate severe complications. Hospital admissions for these conditions have been used to measure the effectiveness of primary health care. We review and compare lists of these conditions developed by national and international health entities to explore their applicability to diverse health care systems, the conditions included and the methodological challenges of making cross-country comparisons. While ambulatory care-sensitive conditions can provide a framework for assessing the performance of health care systems, the relevance of specific conditions or lists depends on the local epidemiological context. Countries have developed lists to address their specific context and priorities, for example, with Brazil focusing on infectious diseases and the United Kingdom emphasizing chronic conditions. We explore case studies of how analyses of these conditions can inform policy aimed at improving the effectiveness and accessibility of primary health care, provide evidence about the prevalence and sociodemographic heterogeneity of these conditions, and how they can be used for cross-country comparisons. The findings underscore the importance of developing context-specific lists of ambulatory care-sensitive conditions when evaluating the performance of primary health care services, promoting informed policy decisions and guiding resource allocation in health care systems. Standardized data collection and coding practices are required to enable meaningful cross-country comparisons and to ensure the effective use of these conditions as a tool to assess and monitor health system performance.
门诊医疗敏感疾病是指那些有效的初级卫生保健服务能够预防住院或减轻严重并发症的疾病。这些疾病的住院情况已被用于衡量初级卫生保健的有效性。我们回顾并比较了国家和国际卫生机构制定的这些疾病清单，以探讨它们在不同卫生保健系统中的适用性、所包含的疾病以及进行跨国比较时的方法学挑战。虽然门诊医疗敏感疾病可为评估卫生保健系统的绩效提供一个框架，但特定疾病或清单的相关性取决于当地的流行病学背景。各国已制定清单以应对其特定背景和优先事项，例如，巴西侧重于传染病，而英国则强调慢性病。我们探讨了案例研究，说明对这些疾病的分析如何为旨在提高初级卫生保健有效性和可及性的政策提供信息，提供有关这些疾病的患病率和社会人口学异质性的证据，以及它们如何用于跨国比较。研究结果强调，在评估初级卫生保健服务绩效、促进明智的政策决策以及指导卫生保健系统资源分配时，制定针对具体情况的门诊医疗敏感疾病清单非常重要。需要标准化的数据收集和编码做法，以进行有意义的跨国比较，并确保有效地将这些疾病用作评估和监测卫生系统绩效的工具。
