Ambulatory care sensitive conditions

December 16th 2015 ...in category Commissioning Excellence

Ambulatory care sensitive conditions (ACSC’s) are conditions where effective community care and case management can help prevent the need for hospital admission. There are 19 ACSC’s identified:

Vaccine preventable

1. Influenza and pneumonia
2. Other vaccine preventable conditions

Chronic

3. Asthma
4. Congestive heart failure
5. Diabetes complications
6. Chronic obstructive pulmonary disease (COPD)
7. Angina
8. Iron-deficiency anaemia
9. Hypertension
10. Nutritional deficiencies

Acute

11. Dehydration and gastroenteritis
12. Pyelonephritis
13. Perforated bleeding ulcer
14. Cellulitis
15. Pelvic inflammatory disease
16. Ear nose and throat infections
17. Dental conditions
18. Convulsions and epilepsy
19. Gangrene

The NHS outcomes framework includes two indicators that measure the age-sex standardised rate of emergency admissions per 100,000 populations for people of all ages:

Unplanned hospitalisation for chronic ambulatory care sensitive conditions (all ages) NHSOF 2.3.i

This indicator indicates how successfully the NHS manages LTC like asthma, diabetes, epilepsy and dementia where optimum management can be achieved in the community.

Emergency admissions for acute conditions what should not usually require hospital admission NHSOP 3a

This indicator looks at conditions that should usually be managed without the patient having to go into hospital this includes things like kidney and urinary tract infections and respiratory infections.

The latest published data for emergency admissions for ACSCs was published by the Health and Social Care information centre (available here) and there are percentage increases identified on UTIs, lobar pneumonia, diarrhoea, cellulitis and viral infections, no change on convulsions and a 1% decrease on acute upper respiratory infections.

Our recent report on the burden of hospital admission in MS shows that several of these ACSC’s apply to MS. The report is available to download here and additionally a further cross sectional analysis of HES data in Parkinson’s disease shows similar reasons in this condition for hospital admission (available here).

Many service users with neurological conditions do not get regular follow ups and are susceptible to these common causes of ACSC admissions. Many are admitted to hospital for what could be a preventable problem – if only they had effective management in the community. CCGs need to focus their attention onto ACSC’s in neurology patients too as well as their general populations.

About the Author


Sue Thomas

Sue Thomas

Chief Executive for Commissioning Excellence

sue.thomas@nhis.com
View more posts by Sue Thomas

December 16th 2015
...in category Commissioning Excellence

Commissioning Excellence

As one of NHS England’s recognised niche specialist commissioning support providers, we offer a full range services to assist you in improving patient outcomes. Our experience covers all long term conditions, with a particular specialism in the field of neurology.

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