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Rates of admission for ambulatory care sensitive conditions in France in 2009-2010: trends, geographic variation, costs, and an international comparison

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  • William B. Weeks

    (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université - INSERM - Institut National de la Santé et de la Recherche Médicale, Dartmouth Institute for Health Policy and Clinical Practice - Geisel School of Medicine at Dartmouth, Geisel School of Medicine at Dartmouth, AMSE - Aix-Marseille Sciences Economiques - EHESS - École des hautes études en sciences sociales - AMU - Aix Marseille Université - ECM - École Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique)

  • Bruno Ventelou

    (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université - INSERM - Institut National de la Santé et de la Recherche Médicale, AMSE - Aix-Marseille Sciences Economiques - EHESS - École des hautes études en sciences sociales - AMU - Aix Marseille Université - ECM - École Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique)

  • Alain Paraponaris

    (SESSTIM - U912 INSERM - Aix Marseille Univ - IRD - Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale - IRD - Institut de Recherche pour le Développement - AMU - Aix Marseille Université - INSERM - Institut National de la Santé et de la Recherche Médicale, AMSE - Aix-Marseille Sciences Economiques - EHESS - École des hautes études en sciences sociales - AMU - Aix Marseille Université - ECM - École Centrale de Marseille - CNRS - Centre National de la Recherche Scientifique)

Abstract

Background: Admissions for ambulatory care sensitive conditions (ACSCs) are considered preventable and indicators of poor access to primary care. We wondered whether per-capita rates of admission for ACSCs in France demonstrated geographic variation, were changing, were related to other independent variables, or were comparable to those in other countries; further, we wanted to quantify the resources such admissions consume. Methods: We calculated per-capita rates of admission for five categories (chronic, acute, vaccination preventable, alcohol-related, and other) of ACSCs in 94 departments in mainland France in 2009 and 2010, examined measures and causes of geographic variation in those rates, computed the costs of those admissions, and compared rates of admission for ACSCs in France to those in several other countries. Results: The highest ACSC admission rates generally occurred in the young and the old, but rates varied across French regions. Over the 2-year period, rates of most categories of ACSCs increased; higher ACSC admission rates were associated with lower incomes and a higher supply of hospital beds. We found that the local supply of general practitioners was inversely associated with rates of chronic and total ACSC admission rates, but that this relationship disappeared if we accounted for patients' use of general practitioners in neighboring departments. ACSC admissions cost 4.755 billion euros in 2009 and 5.066 billion euros in 2010; they consumed 7.86 and 8.74 million bed days of care, respectively. France had higher rates of ACSC admissions than most other countries examined. Conclusions: Because admissions for ACSCs are generally considered a failure of outpatient care, cost French taxpayers substantial monetary and hospital resources, and appear to occur more frequently in France than in other countries, policymakers should prioritize targeted efforts to reduce them.

Suggested Citation

  • William B. Weeks & Bruno Ventelou & Alain Paraponaris, 2016. "Rates of admission for ambulatory care sensitive conditions in France in 2009-2010: trends, geographic variation, costs, and an international comparison," Post-Print hal-01447863, HAL.
  • Handle: RePEc:hal:journl:hal-01447863
    DOI: 10.1007/s10198-015-0692-y
    Note: View the original document on HAL open archive server: https://amu.hal.science/hal-01447863
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    Citations

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    Cited by:

    1. Andreia Pinto & João Vasco Santos & Júlio Souza & João Viana & Cristina Costa Santos & Mariana Lobo & Alberto Freitas, 2020. "Comparison and Impact of Four Different Methodologies for Identification of Ambulatory Care Sensitive Conditions," IJERPH, MDPI, vol. 17(21), pages 1-14, November.
    2. Emmanuel Kemel & Antoine Nebout & Bruno Ventelou, 2021. "To test or not to test? Risk attitudes and prescribing by French GPs," Working Papers hal-03330153, HAL.
    3. Ilaria Natali & Mathias Dewatripont & Victor Ginsburgh & Michel Goldman & Patrick Legros, 2023. "Prescription opioids and economic hardship in France," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 24(9), pages 1473-1504, December.
    4. Spycher, Jacques & Morisod, Kevin & Moschetti, Karine & Le Pogam, Marie-Annick & Peytremann-Bridevaux, Isabelle & Bodenmann, Patrick & Cookson, Richard & Rodwin, Victor & Marti, Joachim, 2024. "Potentially avoidable hospitalizations and socioeconomic status in Switzerland: A small area-level analysis," Health Policy, Elsevier, vol. 139(C).
    5. M. Kamrul Islam & Egil Kjerstad, 2019. "Co-ordination of health care: the case of hospital emergency admissions," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 20(4), pages 525-541, June.

    More about this item

    Keywords

    Preventable admissions; Ambulatory care sensitive conditions; International; Potential cost savings; International comparisons JEL Classification I11; I18; H51;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

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