ASH: Avoidable Scottish Hospitalisations
Admissions for ACSC are those that could potentially be prevented by timely and effective disease management within primary care. ACSC admissions are increasingly used within Scotland as NHS performance indicators. However, key questions remain about the validity of these measures. The aim of the project was to test the robustness of ACSC admissions as indicators of the quality of primary care in Scotland and where appropriate to propose methods for refining these measures so that they might be better used to set targets for and monitor health system performance. Using practice-level data, we explored relationships between quality of and access to primary care services, hospital admissions for a range of ACSCs, and factors that confound and mediate these relationships. The results showed that higher achievement on some quality measures of primary care was associated with reduced ACSC admissions while access to primary care was also associated with ACSC admissions. However, the effects were small and inconsistent and ACSC admissions were associated with several confounding factors such as composition of the practice population.
Outcome and Translation
Our findings can inform the use of ACSC admissions as a health system performance measure in Scotland and internationally. The research identified refinements to the ACSC admissions indicator to improve its utility as a performance measure.
External collaborators: M Dusheiko (University of York); B Guthrie (University of Dundee); L Jorm (University of Western Sydney) and A Leyland (MRC/CSO Social and Public Health Sciences Unit)
Pol, M. van der, Olajide, D., Dusheiko, M., Guthrie, B., Elliott, R.F., Jorm, L.R. and Leyland, A.H. (2015) Avoidable Scottish Hospitalisations (ASH). Final report submitted to Chief Scientist Office.
Pol, M. van der, Olajide, D., Dusheiko, M., Guthrie, B., Elliott, R.F., Jorm, L.R. and Leyland, A.H. (2015) The impact of quality and accessibility of primary care on admissions for Ambulatory Care Sensitive Conditions (ACSCs) in Scotland, CSO Focus on Research, Edinburgh: Chief Scientist Office.
Pol, M. van der, Olajide, D., Dusheiko, M., Elliott, R.F., Guthrie, B., Jorm, L. R. and Leyland, A. H. (2016) 'Does quality and accessibility of primary care reduce admissions for Ambulatory Care Sensitive Conditions (ACSCs) in Scotland?' HERU Policy Brief, University of Aberdeen, June 2016.
Pol, M. van der, Olajide, D., Dusheiko, M., Elliott, R., Guthrie, B., Jorm, L. and Leyland, A.H. (2019) 'The impact of quality and accessibility of primary care on emergency admissions for a range of chronic ambulatory care sensitive conditions (ACSCs) in Scotland: longitudinal analysis', BMC Family Practice, 20(1), 32.
Konstantinidou, M., Olajide, D. and Pol, M. van der (2014) 'The relationship between provider and patient reported quality of primary care. ', Health Economics in the Age of Longevity: a Joint iHEA & ECHE Congress, Trinity College, Dublin, 13-16 July 2014.
Olajide, D., Konstantinidou, M. and Pol, M. van der (2015) 'The relative influence of practice characteristics, patient access, and disease management in primary care on potentially preventable hospitalisations in Scotland', International Health Economics Association (iHEA) 11th World Congress, Milan, Italy, 12-15 July 2015.