Hospitalizations-ambulatory-care-sensitive-conditions

INDICATOR NAME

Name

Rate of hospitalization for Ambulatory Care Sensitive Conditions (ACSCs)

Alternate Name

Hospitalization rate for conditions that can be managed outside hospital

INDICATOR DESCRIPTION

Description

This indicator measures the rate of hospitalization, per 100,000 people aged 0 to 74 years, for one of the following conditions that, if effectively managed or treated earlier, may not have resulted in admission to hospital: asthma, diabetes, chronic obstructive pulmonary disease, heart failure, hypertension, angina and epilepsy. A lower rate is better.

Indicator Status

Active

HQO Reporting tool/product

Public reporting

Dimension

Efficient

Type

Outcome

DEFINITION AND SOURCE INFORMATION

Unit of Measurement

Rate per 100,000 people

Calculation Methods

This indicator is calculated as the numerator divided by the denominator per 100,000 population

Numerator including inclusion/exclusion

The number of inpatient records from acute care hospitals during each fiscal year with any ambulatory care sensitive condition (ACSC) as the most responsible diagnosis.

Inclusions:

Hospitalization with most responsible diagnosis (DXTYPE=M) code of:

Asthma: J45;
Congestive heart failure and pulmonary edema: I50, J81; excluding cases with CCI codes for cardiac surgical procedures (see below);
Diabetes: E10.0, E10.1, E10.63, E10.64, E10.9, E11.0, E11.1, E11.63, E11.9, E13.0, E13.1, E13.63, E13.9, E14.0, E14.1, E14.63, E14.9, E11.64,E13.64,E14.64;
Chronic obstructive pulmonary disease: J41 to J44, J47 or J10.0,J11.0,J12-J16,J18,J20,J21,J22 when J44 is also present as a secondary diagnosis;
Grand mal status and other epileptic convulsions: G40, G41;
Hypertension: I10.0, I10.1, I11; excluding cases with CCI codes for cardiac surgical procedures (see below);
Angina: I20, I23.82, I24.0, I24.8, I24.9, excluding cases with CCI codes for cardiac surgical procedures (see below);

Cardiac surgical procedures for exclusion: J1HA58, 1HA80, 1HA87, 1HB53, 1HB54, 1HB55, 1HB87, 1HD53, 1HD54, 1HD55, 1HH59, 1HH71, 1HJ76, 1HJ82, 1HM57, 1HM78, 1HM80, 1HN71, 1HN80, 1HN87, 1HP76, 1HP78, 1HP80, 1HP82, 1HP83, 1HP87, 1HR71, 1HR80, 1HR84, 1HR87, 1HS80, 1HS90, 1HT80, 1HT89, 1HT90, 1HU80, 1HU90, 1HV80, 1HV90, 1HW78, 1HW79, 1HX71, 1HX78, 1HX79, 1HX80, 1HX83, 1HX86, 1HX87, 1HY85, 1HZ53 rubric (except 1HZ53LAKP), 1HZ55 rubric (except 1HZ55LAKP), 1HZ56, 1HZ57, 1HZ59, 1HZ80, 1HZ85, 1HZ87, 1IF83, 1IJ50, 1IJ55, 1IJ57, 1IJ76, 1IJ86, 1IJ80, 1IK57, 1IK80, 1IK87, 1IN84, 1LA84, 1LC84, 1LD84, 1YY54LANJ.

Exclusions:

Death before discharge.
Patients sign themselves out.
Transfers from another acute care facility.
Patients aged 75 and older.

Denominator including inclusion/exclusion

The number of people in Ontario aged 0 to 74 years.

Exclusions:

Birthdate after April 1st of given fiscal year.
Death date before April 1st of given fiscal year.
Missing sex.
Non-Ontario resident (April 1st of given fiscal year).
Age less than 0 or greater than 74 (April 1st of given fiscal year).
Not eligible for OHIP (April 1st of given fiscal year).

Adjustment (risk, age/sex standardization)- detailed

Direct age-sex standardized rate using the 2011 Canadian population

Data Source

Discharge Abstract Database (DAD), Registered Persons Database (RPDB)

Data provided to HQO by

Institute for Clinical Evaluative Sciences (ICES)

Reported Levels of comparability /stratifications (defined)

Income, Institution, Region, Rurality, Time

OTHER RELEVANT INFORMATION

Caveats and Limitations

This indicator is affected by the health status of the population, since a healthier population will have fewer hospitalizations overall. For example, a population with fewer smokers is likely to have fewer people with lung disease that may require hospitalization.