PMID- 32307101
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231218
IS  - 1578-1860 (Electronic)
IS  - 0014-2565 (Linking)
VI  - 221
IP  - 2
DP  - 2021 Feb
TI  - Wide systematic variations in potentially avoidable hospitalisations of 
      chronically ill patients: Ecological study of basic health areas and healthcare 
      areas.
PG  - 69-75
LID - S0014-2565(20)30098-9 [pii]
LID - 10.1016/j.rce.2020.02.004 [doi]
AB  - BACKGROUND AND OBJECTIVE: Potentially 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 
      METHODS: We 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. RESULTS: Between 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. CONCLUSIONS: The 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.
CI  - Copyright (c) 2020 Elsevier Espana, S.L.U. and Sociedad Espanola de Medicina 
      Interna (SEMI). All rights reserved.
FAU - Angulo-Pueyo, E
AU  - Angulo-Pueyo E
AD  - Grupo de Investigacion en Servicios y Politicas Sanitarias, Instituto Aragones de 
      Ciencias de la Salud (IACS), Zaragoza, Espana; Instituto de Investigacion 
      Sanitaria Aragon (IIS Aragon), Zaragoza, Espana; Red de Investigacion en 
      Servicios de Salud en Enfermedades Cronicas (REDISSEC), Espana.
FAU - Martinez-Lizaga, N
AU  - Martinez-Lizaga N
AD  - Grupo de Investigacion en Servicios y Politicas Sanitarias, Instituto Aragones de 
      Ciencias de la Salud (IACS), Zaragoza, Espana; Instituto de Investigacion 
      Sanitaria Aragon (IIS Aragon), Zaragoza, Espana; Red de Investigacion en 
      Servicios de Salud en Enfermedades Cronicas (REDISSEC), Espana.
FAU - Bernal-Delgado, E
AU  - Bernal-Delgado E
AD  - Grupo de Investigacion en Servicios y Politicas Sanitarias, Instituto Aragones de 
      Ciencias de la Salud (IACS), Zaragoza, Espana; Instituto de Investigacion 
      Sanitaria Aragon (IIS Aragon), Zaragoza, Espana; Red de Investigacion en 
      Servicios de Salud en Enfermedades Cronicas (REDISSEC), Espana. Electronic 
      address: ebernal.iacs@aragon.es.
CN  - En representacion del grupo Atlas VPM
LA  - eng
LA  - spa
PT  - Journal Article
TT  - Amplias variaciones sistematicas en hospitalizaciones potencialmente evitables en 
      pacientes cronicos: estudio ecologico sobre zonas basicas de salud y areas 
      sanitarias.
DEP - 20200416
PL  - Spain
TA  - Rev Clin Esp
JT  - Revista clinica espanola
JID - 8608576
OTO - NOTNLM
OT  - Accesibilidad a servicios sanitarios
OT  - Ambulatory care-sensitive conditions
OT  - Analisis de area pequena
OT  - Chronic disease
OT  - Condiciones sensibles a cuidados ambulatorios
OT  - Continuidad de ciudados
OT  - Continuity of patient care
OT  - Enfermedad cronica
OT  - Health services accessibility
OT  - Small area analysis
EDAT- 2020/04/21 06:00
MHDA- 2020/04/21 06:01
CRDT- 2020/04/21 06:00
PHST- 2019/10/01 00:00 [received]
PHST- 2020/02/11 00:00 [revised]
PHST- 2020/02/14 00:00 [accepted]
PHST- 2020/04/21 06:01 [medline]
PHST- 2020/04/21 06:00 [pubmed]
PHST- 2020/04/21 06:00 [entrez]
AID - S0014-2565(20)30098-9 [pii]
AID - 10.1016/j.rce.2020.02.004 [doi]
PST - ppublish
SO  - Rev Clin Esp. 2021 Feb;221(2):69-75. doi: 10.1016/j.rce.2020.02.004. Epub 2020 
      Apr 16.