Analysis of the influence of the process of care in primary health care on avoidable hospitalizations for heart failure

Published: June 15, 2015
Category: Bibliography > Papers
Authors: Alberquilla Menendez-Asenjo A, Camacho Hernandez AM, Del Saz Moreno V, Enriquez de Salamanca Lorente R, Lora Pablos D, Magan Tapia P
Countries: Spain
Language: null
Types: Care Management, Performance Analysis
Settings: Hospital, PCP

Aten Primaria 48:102-109. Published in Spanish.

Hospital Universitario Infanta Sofía, Madrid, España; Unidad Docente Multiprofesional de Atención Familiar y Comunitaria; Madrid, España; Unidad Sistemas de Información de Atención Primaria, Madrid, España; Hospital Universitario, Madrid, España; Centro de Salud Pavones, Madrid, Spain

OBJECTIVE: To determine if the process of care in primary health, affects the risk of avoidable hospitalizations for ambulatory care sensitive conditions (ACSH) for heart failure (HF).

DESIGN: Case-control study analyzing the risk of hospitalization for HF. The exposure factor was the process of care for HF in primary health.

LOCATION: Health area of the region of Madrid (n=466.901).

PARTICIPANTS: There were included all adult patients (14 years or older) with a documented diagnosis of HF in the electronic medical record of primary health (n=3.277). The cases were patients who were hospitalized for HF while the controls did not require admission, during 2007.

MAIN MEASUREMENTS: risk of ACSH for HF related to the process of care considered both overall and for each separate standard of appropriate care. Differences in clinical complexity of the groups were measured using the Adjusted Clinical Group (ACG) classification system.

RESULTS: 227 cases and 3.050 controls. Clinical complexity was greater in cases. The standards of appropriate care were met to a greater degree in the control group, but none of the two groups met all the standards that would define a process of care as fully appropriate. A significantly lower risk of ACSH was seen for only two standards of appropriate care. For each additional standard of appropriate care not met, the probability of admission was significantly greater (OR: 1,33, 95% CI: 1,19-1,49).

CONCLUSION: Higher quality in the process of care in primary health was associated with a lower risk of hospitalization for HF.

PMID: 26087663

Spain,Resource Use,Performance Assessment,Predictive Risk Modeling,Atención Primaria de Salud,Evaluación de proceso (Atención de Salud),Heart failure,Hospitalización,Hospitalization,Indicadores de calidad de la Atención de Salud,Insuficiencia cardiaca,Primary Health Care,Process Assessment (Health Care),Quality indicators

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