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Revista Uruguaya de Medicina Interna
On-line version ISSN 2393-6797
Abstract
SOLLAZZO, Ana; KUSTER, Ana; BURROSO, Gustavo and ALEMAN, Alicia. Avoidable hospitalizations for health problems sensitive to outpatient care: construction and validation of the Uruguayan list of pathologies. Rev. Urug. Med. Int. [online]. 2024, vol.9, e302. Epub Dec 01, 2024. ISSN 2393-6797. https://doi.org/10.26445/09.01.2.
Introduction:
Hospitalizations for Ambulatory Care Sensitive Conditions is an indicator that measures the use of hospital services for health problems that could have been prevented at the first level of care. The concept refers to the processes in which effective outpatient care can help reduce the risks of hospitalization, at a second level of care. The objective of the study was to build and validate a Uruguayan list of health problems sensitive to outpatient care (PSS-CA) according to ICD-10.
Methodology:
To construct the initial list of PSSCA codes, a review of the existing lists was carried out and an initial list was proposed that was validated through the Delphi Method. A list of 99 PSSCA diagnostic codes adapted to our healthcare environment is proposed. They make it possible to identify and quantify health problems that can lead to potentially avoidable hospitalizations through accessible and timely outpatient care at the first level of care.
Results:
A panel of 12 experts was formed. From the data obtained, considering the 99 diagnoses classified by ICD-10, these can be subclassified depending on whether the pathology is infectious or not, obtaining a general result of 62 pathologies in a total of 99 that can be classified as infectious, which corresponds to 62%.
Discussion:
From the comparison of the Uruguayan list of PSSCA that we have arrived at and the validated lists used for the initial construction of the proposed list of pathologies, we can say that the first presents a higher percentage of coincidence with the list of pathologies of Bello Horizonte . We can mention that most of the health problems identified based on the PSSCA list are sensitive to being resolved with timely and quality primary care that could prevent or significantly reduce hospitalization.
Conclusions:
This work describes the process of construction and validation of a list of PSSCA codes adapted to the Uruguayan context through the Delphi method. We have arrived at a list that includes a total of 99 diagnoses, grouped into a total of nineteen categories that consider the specificity of the Uruguayan context of the indicator.
Keywords : Ambulatory care sensitive conditions (ACSC); Health Care Evaluation Mechanisms; Validation Study; Primary Health Care.