Las hospitalizaciones potencialmente evitables en los hospitales públicos de Extremadura

Abstract

Background: Since the health-care reform in Spain there have been attempts to measure the quality of primary care results. One example is identifying potentially avoidable hospitalisations (PAH) and studying what factors may explain variation in rates. In studies from Spain, PAH�s ranged from 2.8 to 16.5% of hospital admissions, with rates from 30.4 to 262.7 per 10,000 inhabitants. Objectives: To quantify PAH rates in adults and their variability, to map these rates in Extremadura, to study their association with geographic, socio-economic and organizational factors, and to determine an acceptable level of PAH. Design: Ecological cross-sectional study, using basic health areas (BHA) as the unit of analysis. Setting: Public hospitals within Extremadura. Adult hospital discharges from 2009, 1 January to 2010, 31 December. Methods: Age-gender standardised PAH rates and standardised hospitalization ratios by BHA were calculated and mapped. Rates by condition, age, gender and hospital area were also calculated. The association of these variables with BHA and hospital area factors was assessed. Main results: PAH accounted for 4.81% of admissions (Standardised rate, 42.64 per 10,000 population). Most prevailing conditions were heart failure and COPD. PAH rates ranged from 14.27 to 117.41 per 10,000 inhabitants among BHA. HPE rates were statistically associated with GP workload, distance to hospital and bed supply in the Hospital Area.