This measure looks at the rate of inpatient admission and observation stay discharges for ambulatory care sensitive conditions (ACSC) per 1,000 members. It also measures the risk-adjusted ratio of observed-to-expected discharges for ACSC among members 67 years of age and older.
Why it Matters
ACSCs are acute and chronic health conditions that can be managed or treated in the outpatient setting. Appropriate access to care, high-quality care coordination, a focus on chronic disease self-management and connection to community resources can reduce the probability that individuals with ACSC will develop complications resulting in a hospitalization.
Hospitalization poses several risks for older adults, who frequently develop serious conditions as a result of hospitalization. These include delirium, infection and decline in functional ability. Reducing hospitalization rates for older adults will improve patient health, reduce costs and improve quality of life.
Because not all complications that result in hospitalizations are preventable, the goal of this measure is not to obtain a rate of no (zero) hospitalizations. Instead, it should be to provide valuable information about how well a system of care helps older adults prevent hospitalizations.
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Gillick, M.R., N.A. Serrell, and L.S. Gillick. 1982. Adverse consequences of hospitalization in the elderly. Social science & medicine. 16(10), 1033–8.
Covinsky, K.E., E. Pierluissi, and C.B. Johnston. 2011. Hospitalization-associated disability. JAMA: The Journal of the American Medical Association. 306(16), 1782–93.