Potentially preventable emergency hospital admissions
Unplanned hospital admissions are both costly and frequently unpleasant experiences for patients. Many hospital admissions related to long-term conditions could be avoided, if timely and effective care is provided to the patient in the community. These conditions are known as ambulatory care-sensitive (ACS) conditions. Here we look at admission for all ACS conditions in England, and three common chronic conditions - chronic obstructive pulmonary disease (COPD), asthma and diabetes - internationally.
There are many different definitions of which conditions should be considered as ACS. The definitions used here are listed in the online appendix to our Focus on Preventable admissions report. For a discussion of the various ways of defining an ACS admission, see Purdy and others (2009).
Definitions and comparability for all the indicators discussed in this report are taken directly from the OECD report Health at a Glance 2013: OECD indicators . Detailed information about the definitions and the source and methods for each country can be found here.
The asthma and COPD indicators are defined as the number of hospital discharges of people aged 15 years and over per 100 000 population.
The indicator for diabetes is based on the sum of three indicators: admissions for short-term and long-term complications and for uncontrolled diabetes without complications. Rates were age-sex standardised to the 2010 OECD population aged 15 and over. Differences in coding practices among countries and the definition of an admission may affect the comparability of data. Differences in disease classification systems, for example between ICD-9-CM and ICD-10-AM, may also affect data comparability.
One of the problems with these indicators is that they look at hospital admissions and do not take account of underlying differences in the prevalence of different conditions. For example, with regard to diabetes, it is not always clear whether lower admission rates are due to a lower prevalence of diabetes in the population or better management of people with diabetes. However, there are several ongoing OECD initiatives that focus on coding practices, dataset structure and data specification, with the aim of making the indicators more useful for international comparison.