NDLI: “Evolution and financial cost of socioeconomic inequalities in ambulatory care sensitive conditions: an ecological study for Portugal, 2000

Content Provider	Springer Nature : BioMed Central
Author	Dimitrovová, Klára Costa, Cláudia Santana, Paula Perelman, Julian
Abstract	Background Hospitalizations for Ambulatory Care Sensitive Conditions (ACSC) are specific conditions for which hospitalization is thought to be avoidable through patient education, health promotion initiatives, early diagnosis and by appropriate chronic disease management, and have been shown to be greatly influenced by socioeconomic (SE) characteristics. We examined the SE inequalities in hospitalization rates for ACSC in Portugal, their evolution over time (2000–2014), and their associated financial burden. Methods We modeled municipality-level ACSC hospitalization rates per 1000 inhabitants and ACSC hospitalization-related costs per inhabitant, for the 2000–2014 period (n = 4170), as a function of SE indicators (illiteracy and purchasing power, in quintiles), controlling for the proportion of elderly, sex, disease specific mortality rate, population density, PC supply, and time trend. The evolution of inequalities was measured interacting SE indicators with a time trend. Costs attributable to ACSC related hospitalization inequalities were measured by the predicted values for each quintile of the SE indicators. Results Hospitalization rate for ACSC was significantly higher in the 4th quintile of illiteracy compared with the 1st quintile (beta = 1.97; p < 0.01), and significantly lower in the 5th quintile of purchasing power, compared with the 1st quintile (beta = − 1.19; p < 0.05). ACSC hospitalization-related costs were also significantly higher in the 4th quintile of illiteracy compared with the 1st quintile (beta = 4.04€; p < 0.05), and significantly lower in the 5th quintile of purchasing power, compared with the 1st quintile (beta = − 4,69€; p < 0.01). The SE gradient significantly increased over the 2000–2014 period, and the annual cost of inequalities were estimated at more than 15 million euros for the Portuguese NHS. Conclusion There was an increasing SE patterning in ACSC related hospitalizations, possibly reflecting increasing SE inequalities in early and preventive high-quality care, imposing a substantial financial burden to the Portuguese NHS.
Related Links	https://equityhealthj.biomedcentral.com/counter/pdf/10.1186/s12939-017-0642-7.pdf
Ending Page	11
Page Count	11
Starting Page	1
File Format	HTM / HTML
ISSN	14759276
DOI	10.1186/s12939-017-0642-7
Journal	International Journal for Equity in Health
Issue Number	1
Volume Number	16
Language	English
Publisher	BioMed Central
Publisher Date	2017-08-16
Access Restriction	Open
Subject Keyword	Public Health Health Promotion and Disease Prevention Health Services Research Health Policy Social Justice Equality and Human Rights Social Policy Ambulatory care sensitive conditions Primary care Socioeconomic inequalities Costs
Content Type	Text
Resource Type	Article
Subject	Health Policy Public Health, Environmental and Occupational Health
Journal Impact Factor	4.5/2023
5-Year Journal Impact Factor	4.7/2023

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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