Using geographic variation in unplanned ambulatory care sensitive condition admission rates to identify commissioning priorities: An analysis of routine data from England

John Busby*, Sarah Purdy, William Hollingworth

*Corresponding author for this work

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives: To use geographic variation in unplanned ambulatory care sensitive condition admission rates to identify the clinical areas and patient subgroups where there is greatest potential to prevent admissions and improve the quality and efficiency of care. Methods: We used English Hospital Episode Statistics data from 2011/2012 to describe the characteristics of patients admitted for ambulatory care sensitive condition care and estimated geographic variation in unplanned admission rates. We contrasted geographic variation across admissions with different lengths of stay which we used as a proxy for clinical severity. We estimated the number of bed days that could be saved under several scenarios. Results: There were 1.8 million ambulatory care sensitive condition admissions during 2011/2012. Substantial geographic variation in ambulatory care sensitive condition admission rates was commonplace but mental health care and short-stay (<2 days) admissions were particularly variable. Reducing rates in the highest use areas could lead to savings of between 0.4 and 2.8 million bed days annually. Conclusions: Widespread geographic variations in admission rates for conditions where admission is potentially avoidable should concern commissioners and could be symptomatic of inefficient care. Further work to explore the causes of these differences is required and should focus on mental health and short-stay admissions.

Original languageEnglish
Pages (from-to)20-27
Number of pages8
JournalJournal of Health Services Research and Policy
Volume22
Issue number1
DOIs
Publication statusPublished - 01 Jan 2017

Keywords

  • Ambulatory care sensitive admissions
  • Geography
  • Hospital admission

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

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