000060669 001__ 60669
000060669 005__ 20190709135436.0
000060669 0247_ $$2doi$$a10.1136/bmjopen-2016-011844
000060669 0248_ $$2sideral$$a98078
000060669 037__ $$aART-2017-98078
000060669 041__ $$aeng
000060669 100__ $$aAngulo-Pueyo, E.
000060669 245__ $$aFactors associated with hospitalisations in chronic conditions deemed avoidable: Ecological study in the Spanish healthcare system
000060669 260__ $$c2017
000060669 5060_ $$aAccess copy available to the general public$$fUnrestricted
000060669 5203_ $$aObjectives: Potentially avoidable hospitalisations have been used as a proxy for primary care quality. We aimed to analyse the ecological association between contextual and systemic factors featured in the Spanish healthcare system and the variation in potentially avoidable hospitalisations for a number of chronic conditions. Methods: A cross-section ecological study based on the linkage of administrative data sources from virtually all healthcare areas (n=202) and autonomous communities (n=16) composing the Spanish National Health System was performed. Potentially avoidable hospitalisations in chronic conditions were defined using the Spanish validation of the Agency for Health Research and Quality (AHRQ) preventable quality indicators. Using 2012 data, the ecological association between potentially avoidable hospitalisations and factors featuring healthcare areas and autonomous communities was tested using multilevel negative binomial regression. Results: In 2012, 151 468 admissions were flagged as potentially avoidable in Spain. After adjusting for differences in age, sex and burden of disease, the only variable associated with the outcome was hospitalisation intensity for any cause in previous years (incidence risk ratio 1.19 (95% CI 1.13 to 1.26)). The autonomous community of residence explained a negligible part of the residual unexplained variation (variance 0.01 (SE 0.008)). Primary care supply and activity did not show any association. Conclusions: The findings suggest that the variation in potentially avoidable hospitalisations in chronic conditions at the healthcare area level is a reflection of how intensively hospitals are used in a healthcare area for any cause, rather than of primary care characteristics. Whether other non-studied features at the healthcare area level or primary care level could explain the observed variation remains uncertain.
000060669 536__ $$9info:eu-repo/grantAgreement/ES/MICINN/ISCIII-RD12-0001-0004
000060669 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000060669 590__ $$a2.413$$b2017
000060669 591__ $$aMEDICINE, GENERAL & INTERNAL$$b43 / 154 = 0.279$$c2017$$dQ2$$eT1
000060669 592__ $$a1.372$$b2017
000060669 593__ $$aMedicine (miscellaneous)$$c2017$$dQ1
000060669 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000060669 700__ $$aRidao-López, M.
000060669 700__ $$aMartínez-Lizaga, N.
000060669 700__ $$aGarcía-Armesto, S.
000060669 700__ $$aPeiró, S.
000060669 700__ $$0(orcid)0000-0002-0961-3298$$aBernal-Delgado, E.
000060669 773__ $$g7, 2 (2017), [7 pp.]$$pBMJ Open$$tBMJ open$$x2044-6055
000060669 8564_ $$s700811$$uhttps://zaguan.unizar.es/record/60669/files/texto_completo.pdf$$yVersión publicada
000060669 8564_ $$s35030$$uhttps://zaguan.unizar.es/record/60669/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000060669 909CO $$ooai:zaguan.unizar.es:60669$$particulos$$pdriver
000060669 951__ $$a2019-07-09-11:34:28
000060669 980__ $$aARTICLE