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Revista clínica española · Feb 2021
Wide systematic variations in potentially avoidable hospitalisations of chronically ill patients: Ecological study of basic health areas and healthcare areas.
- E Angulo-Pueyo, N Martínez-Lizaga, E Bernal-Delgado, and En representación del grupo Atlas VPM.
- Grupo de Investigación en Servicios y Políticas Sanitarias, Instituto Aragonés de Ciencias de la Salud (IACS), Zaragoza, España; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, España; Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), España.
- Rev Clin Esp. 2021 Feb 1; 221 (2): 697569-75.
Background And ObjectivePotentially avoidable hospitalisations (PAHs) due to chronic conditions are a healthcare problem that could reflect healthcare of insufficient quality. This study reports the systematic variations in PAHs for the collection of providers of the Spanish National Health System.Materials And MethodsWe conducted an ecological study on government data, analysing the systematic variation in PAHs for 6 chronic conditions during 2013-2015. To determine the variation, we performed a small area analysis using Bayesian methodology.ResultsBetween 2013 and 2015, 439,878 admissions for PAHs were recorded in the Spanish National Health System. There was an up to 4-fold difference in PAH rates between certain basic health areas (BHA), with highly variable differences depending on the analysed condition. Forty percent of the BHAs showed a greater than expected risk of PAH. Beyond the systematic variation observed between BHAs, the healthcare areas of the patients' residence explained 33% of the variation in PAHs. We observed specific differences in these general results according to clinical condition, age and sex.ConclusionsThe wide systematic variation in PAHs suggests a problem of quality in the care provided to chronically ill patients by the providers of healthcare areas in Spain. Identifying and analysing these areas and other healthcare areas with better results could provide a reference for improving the care of other suppliers with poorer performance.Copyright © 2020 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.
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