[Ambulatory care-sensitive conditions in Germany: a small area analysis (2006-2009)]. 2015

C Naumann, and U Augustin, and L Sundmacher
Fachgebiet Versorgungsforschung und Qualitätsmanagement im ambulanten Sektor, Technische Universität Berlin, Berlin.

OBJECTIVE The paper aims (1) to identify and depict cartographically ambulatory care-sensitive conditions in Germany (based on data for the years 2006-2009) and (2) to discuss the implications. METHODS The selection of ambulatory care-sensitive conditions (ACSC) was based on a literature review by Purdy et al. (2009) because a German catalogue of ACSC does not yet exist. Five of these indications were excluded due to limited data -access or a low number of cases. Additionally, 2 -diagnoses that are potentially relevant for Germany were included. Subsequently, diagnosis-specific hospitalisation rates were calculated for each of the 412 counties (Stadtkreise and Landkreise). The spatial distribution of 6 selected diag-noses (heart failure, diabetes, dehydration and gastroenteritis, ENT infections, influenza and pneumonia as well as schizophrenia) was depicted and discussed. Furthermore, an overall analysis of diagnoses analysis was performed. RESULTS Based on the overall analysis, counties with high hospitalisation rates were identified in Mecklenburg-Western Pomerania, Saxony-Anhalt and Thuringia as well as to a lesser degree in Brandenburg, Saarland, Rhineland Palatinate and North Rhine-Westphalia (for men and women). Low hospitalisation rates were often present in counties in Baden-Wuerttemberg. Based on the diagnosis-specific analysis, some regional clusters could be identified. Thus, high hospitalisa-tion rates for heart failure, diabetes, ENT infections were especially present in Eastern Germany. In contrast, there were no distribution patterns for high hospitalisation rates due to influenza and pneumonia. However, differences could be also identified between rural and urban regions: while hospitalisations due to dehydration and gastroenteritis were more often in rural -districts, hospitalisations due to schizophrenia occurred more frequently in urban regions. CONCLUSIONS Knowledge of the spatial distribution of ACSC -rates serves as an important indicator for the identification of districts where health-care quality and access (structural--related) can be optimised. The analysis of hospitalisation rates for 6 selected indications showed that for some indications there were clear regional differences in the distribution of ACSCs in -Germany.

UI MeSH Term Description Entries
D007223 Infant A child between 1 and 23 months of age. Infants
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D007239 Infections Invasion of the host organism by microorganisms or their toxins or by parasites that can cause pathological conditions or diseases. Infection,Infection and Infestation,Infections and Infestations,Infestation and Infection,Infestations and Infections
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D002947 Cities A large or important municipality of a country, usually a major metropolitan center. Municipalities,Towns
D003681 Dehydration The condition that results from excessive loss of water from a living organism. Water Stress,Stress, Water
D003920 Diabetes Mellitus A heterogeneous group of disorders characterized by HYPERGLYCEMIA and GLUCOSE INTOLERANCE.

Related Publications

C Naumann, and U Augustin, and L Sundmacher
June 2013, Population health management,
C Naumann, and U Augustin, and L Sundmacher
January 2014, Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen,
C Naumann, and U Augustin, and L Sundmacher
March 2016, Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)),
C Naumann, and U Augustin, and L Sundmacher
April 2012, Revista de saude publica,
C Naumann, and U Augustin, and L Sundmacher
June 2016, Journal of community health,
C Naumann, and U Augustin, and L Sundmacher
March 2005, Medicine and health, Rhode Island,
C Naumann, and U Augustin, and L Sundmacher
January 2014, Social work in public health,
C Naumann, and U Augustin, and L Sundmacher
August 2013, Revista da Escola de Enfermagem da U S P,
Copied contents to your clipboard!