Atlas of avoidable hospitalisations in Australia: ambulatory care-sensitive conditions

Avoidable hospitalisations represent a range of conditions for which hospitalisation should be able to be avoided because the disease or condition has been prevented from occurring, or because individuals have had access to timely and effective primary care. This report addresses the level and extent of regional variation in Australia in a sub-set of avoidable hospitalisations, namely those arising from ambulatory care-sensitive (ACS) conditions.

ACS conditions are certain conditions for which hospitalisation is considered potentially avoidable through preventive care and early disease management, usually delivered in a primary care setting, for example by a general medical practitioner, or at a community health centre. They can be used as an indicator to assess the adequacy, efficiency and quality of primary health care within the broader health system. Analyses at the area level may assist as a tool to monitor need; as a performance indicator of variations in access to, or the quality of, primary care; or in allocating limited resources among communities.

Admissions for these conditions can be avoided in three ways. Firstly, for conditions that are usually preventable through immunisation, disease can be prevented almost entirely. Secondly, diseases or conditions that can lead to rapid onset of problems, such as dehydration and gastroenteritis, can be treated. Thirdly, chronic conditions, such as congestive heart failure, can be managed to prevent or reduce the severity of acute flare-ups to avoid hospitalisation.

The analysis is presented for the individual ambulatory care-sensitive conditions, and for these conditions grouped into three sub-categories: conditions that can be prevented through vaccination; acute conditions for which hospitalisations are commonly avoidable with antibiotics or other medical interventions available in primary care; and selected chronic conditions that can be managed by pharmaceuticals, patient education, and lifestyle.

This report does not cover other aspects of avoidable hospitalisations, namely preventable hospitalisations, a sub-category of avoidable hospitalisations, comprising hospitalisations of people from diseases preventable through population-based health promotion strategies (e.g. alcohol-related conditions and most cases of lung cancer); or hospitalisations potentially avoidable through injury prevention strategies (e.g. road traffic accidents). Currently, there is no agreed approach to the categorisation of these aspects of avoidable hospitalisations in Australia, or internationally.