Publication: From Scheme to System: Understanding the Concept and Measurement of Hospitalizations for Ambulatory-Care-Sensitive Conditions

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Date
2023-09-18
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Published
2023-09-18
Author(s)
Tandon, Ajay
Chandrashekar, Sudha
Chhabra, Sheena
Manchanda, Navneet Kaur
Abstract
Ambulatory Care Sensitive Conditions (ACSCs) - conditions for which hospitalization could be prevented or reduced with timely access to effective preventive and early disease management services in primary health care outpatient settings—has emerged as a valuable concept for assessing disparities in healthcare access and utilization among vulnerable populations. This paper provides an overview of the concept of ACSCs and explores its potential for measurement in low-and middle-income countries, using India as a case study. Hospitalization or claims data for ACSCs are increasingly used globally to assess the access to and quality of primary health care services. Analyzing trends in hospital admissions for ACSCs can provide critical policy-relevant information as effective management of ACSCs can lead to reduced hospitalizations, lower morbidity, and mortality, and reduced cost pressures on health systems. The paper highlights the relevance of ACSC analysis in the context of India's flagship health sector reforms—Ayushman Bharat—which aims to achieve universal health coverage. Monitoring and analyzing hospitalizations for ACSCs under Pradhan Mantri Jan Arogya Yojana (PM-JAY)- the world's largest health insurance scheme and one of the four pillars of Ayushman Bharat- will allow decision-makers to assess the magnitude of preventable hospital admissions from an economic efficiency and patient well-being perspective and enable them to make informed policy decisions on strengthening the quality of primary healthcare services. .
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Tandon, Ajay; Chandrashekar, Sudha; Chhabra, Sheena; Manchanda, Navneet Kaur. 2023. From Scheme to System: Understanding the Concept and Measurement of Hospitalizations for Ambulatory-Care-Sensitive Conditions. © Washington, DC: World Bank. http://hdl.handle.net/10986/40361 License: CC BY-NC 3.0 IGO.
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