Ambulatory care sensitive chronic conditions: what can we learn from patients about the role of primary health care in preventing admissions?
Jo M. Longman A C , Elizabeth Rix B , Jennifer J. Johnston A and Megan E. Passey A
+ Author Affiliations
- Author Affiliations
A The University of Sydney, School of Rural Health, University Centre for Rural Health, 61 Uralba Street, Lismore, NSW 2480, Australia.
B Southern Cross University, Military Road, East Lismore, NSW 2480, Australia.
C Corresponding author. Email: jo.longman@sydney.edu.au
Australian Journal of Primary Health 24(4) 304-310 https://doi.org/10.1071/PY17191
Submitted: 20 December 2017 Accepted: 9 May 2018 Published: 6 August 2018
Abstract
Developing and targeting interventions to reduce hospital admissions for ambulatory care sensitive (ACS) chronic conditions for older people is a key focus for improvement of the health system. To do this, an understanding of any modifiable factors that may contribute to such admissions is needed. To date, the literature on ACS admissions has rarely included the patient perspective. This qualitative study involved one-to-one telephone interviews with 24 patients aged ≥45 years who had had an unplanned admission for an ACS chronic condition to one of two participating regional hospitals between February and August 2015. Data were transcribed and analysed thematically. Most participants did not perceive their admission to be preventable, yet they described a series of interlinking factors, which may have contributed to their admission and which may offer potential points of leverage. Key interlinked themes interpreted were: ‘support deficits’, ‘non-adherence to treatment’ (including medication), ‘mental health’ and ‘lack of awareness or understanding of condition’. Improving system-, clinician- and patient-level factors within a framework of appropriately resourced and supported comprehensive primary health care that is accessible, affordable, holistic, practical and evidence-based may contribute to improving patients’ quality of life and to delaying or preventing hospital admission.
Additional keywords: ambulatory care, avoidable admission, chronic disease, help-seeking behaviour, multimorbidity, preventable hospitalisation, qualitative research.
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