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       #Post#: 228--------------------------------------------------
       Which admissions are avoidable?
       By: admini5 Date: May 13, 2015, 7:58 am
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       Ambulatory or primary care sensitive conditions (ACSCs) are
       those for which hospital admission could be prevented by
       interventions in primary care (Bindman et al 1995; Purdy et al
       2010c). At present, different sets of ACSCs are used in
       different situations. The most common ACSCs in England are based
       on a set of conditions initially derived to measure access to
       primary care in the United States; these were then refined for
       use in Australia (Agency for Healthcare Research and Quality
       2001; NHS Institute for Innovation and Improvement 2007).
       Some admissions (eg, those for dementia) may not be perceived to
       be avoidable, as the disease course is not significantly
       modifiable. However, the availability of more suitable
       alternatives to an acute hospital admission – for example,
       respite care or home care – can result in admission
       avoidance in the acute situation. This concept of an ACSC, which
       is dependent on availability and referral to an alternative
       service, is very different to the original American concept of
       the ACSC as a marker of availability of traditional clinical
       ambulatory or primary care.
       Commissioners and other stakeholders will inevitably prioritise
       the conditions that  are of interest to them according to
       different criteria, which will vary depending on the viewpoint
       of the stakeholder. These priorities will also vary across
       health care systems, depending on the prevalence of the ACSCs
       and the economic and policy drivers in the local health care
       economy.
       Recommendation:
       
       they consider to be avoidable, what proportion of these
       admissions are avoidable, and how these admissions should be
       coded and measured.
       For further information, please visit:
  HTML http://www.kingsfund.org.uk/sites/files/kf/Avoiding-Hospital-Admissions-Sarah-Purdy-December2010.pdf
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