Organizational aspects of primary care related to avoidable hospitalization: a systematic review.

摘要: BACKGROUND: Often used indicators for the quality of primary care are hospital admissions rates conditions which potentially avoidable by well-functioning care. Such hospitalizations frequently termed as ambulatory sensitive (ACSCs). OBJECTIVE: We aim to investigate characteristics organization influence hospitalization chronic ACSCs. METHODS: MEDLINE, Embase and SciSearch were searched publications on Studies included if peer reviewed, written in English, published between January 1997 November 2013, conducted high income countries, identified ACSC outcome measures researched A risk bias assessment was performed assess articles. FINDINGS: total 1778 49 met inclusion criteria. Twenty-two factors found. Factors clustered into four clusters: system-level characteristics, accessibility, structural organizational process. Adequate physician supply better longitudinal continuity reduced hospitalizations. Furthermore, inconsistent results found effectiveness various disease management programs reducing rates. CONCLUSIONS: Available evidence suggests that strong terms adequate long-term relationships physicians patients reduces There is a lack positive effects many other aspects, such specific programs.