Papers

Peer-reviewed
Dec, 2019

Admissions for ambulatory care sensitive conditions on rural islands and their association with patient experience: a multicentred prospective cohort study.

BMJ open
  • Kaneko M
  • Aoki T
  • Funato M
  • Yamashiro K
  • Kuroda K
  • Kuroda M
  • Saishoji Y
  • Sakai T
  • Yonaha S
  • Motomura K
  • Inoue M
  • Display all

Volume
9
Number
12
First page
e030101
Last page
e030101
Language
Publishing type
Research paper (scientific journal)
DOI
10.1136/bmjopen-2019-030101
Publisher
BMJ

<sec><title>Objectives</title>The rate of admissions for ambulatory care sensitive conditions (ACSCs) is a key outcome indicator for primary care, and patient experience (PX) is a crucial process indicator. Studies have reported higher rates of admission for ACSCs in rural areas than in urban areas. Whether there is an association between admissions for ACSCs and PX in rural areas has not been examined. This study aimed to document admissions for ACSCs on Japanese rural islands, and assess whether there was an association between the rate of admissions for ACSCs and PX.

</sec><sec><title>Design</title>Multicentred, prospective, cohort study

</sec><sec><title>Setting</title>This study was conducted on five rural islands in Okinawa, Japan.

</sec><sec><title>Participants</title>The study participants were all island inhabitants aged 65 years or older.

</sec><sec><title>Primary outcome measures</title>This study examined the association between ACSCs and PX assessed by a questionnaire, the Japanese Version of Primary Care Assessment Tool. ACSCs were classified using the International Classification of Diseases, Tenth Revision, and the rate of admissions for ACSCs in 1 year.

</sec><sec><title>Results</title>Of 1258 residents, 740 completed the questionnaire. This study documented 38 admissions for ACSCs (29 patients, males/females: 15/14, median age 81.9) that included congestive heart failure (11), pneumonia (7) and influenza (5). After adjusting for covariates and geographical clustering, admissions for ACSCs had a significant positive association with each patient’s PX scores (OR per 1 SD increase=1.62, 95% CI 1.02–2.61).

</sec><sec><title>Conclusions</title>Physicians serving rural areas need to stress the importance of preventive interventions for heart failure, pneumonia and influenza to reduce the number of admissions for ACSCs. Contrary to previous studies, our findings might be explained by close patient–doctor relationships on the rural islands.

</sec>

Link information
DOI
https://doi.org/10.1136/bmjopen-2019-030101
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/31888923
URL
https://syndication.highwire.org/content/doi/10.1136/bmjopen-2019-030101
ID information
  • DOI : 10.1136/bmjopen-2019-030101
  • ISSN : 2044-6055
  • eISSN : 2044-6055
  • Pubmed ID : 31888923

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