eprintid: 24249
rev_number: 10
eprint_status: archive
userid: 1589
dir: disk0/00/02/42/49
datestamp: 2018-04-17 09:26:35
lastmod: 2018-05-17 12:06:51
status_changed: 2018-04-17 09:26:35
type: article
metadata_visibility: show
creators_name: Lichtl, Célina
creators_name: Lutz, Thomas
creators_name: Szecsenyi, Joachim
creators_name: Bozorgmehr, Kayvan
title: Differences in the prevalence of hospitalizations and utilization of emergency outpatient services for ambulatory care sensitive conditions between asylum-seeking children and children of the general population: a cross-sectional medical records study (2015)
subjects: 610
divisions: 910100
abstract: Background Hospitalizations for ambulatory care sensitive (ACS) conditions are established indicators for the availability and quality of ambulatory care. We aimed to assess the differences between asylum-seeking children and children of the general population in a German city with respect to (i) the prevalence of ACS hospitalizations, and (ii) the utilization of emergency outpatient services for ACS conditions.   Methods Using anonymous account data, all children admitted to the University Hospital Heidelberg in 2015 were included in our study. A unique cost unit distinguished asylum seekers residing in a nearby reception center (exposed) from the children of the general population. We adapted international lists of ACS conditions and calculated the prevalence of ACS hospitalizations and the utilization of emergency outpatient services for ACS conditions, attributable fractions among the exposed (Afe) and the population attributable fraction among total admissions (PAF) for each outcome. Differences in the prevalence of each outcome between exposed and controls were analyzed in logistic regression models adjusted for sex, age group and quarterly admission.   Results Of the 32,015 admissions in 2015, 19.9% (6287) were from inpatient and 80.1% (25,638) from outpatient care. In inpatient care, 9.8% (622) of all admissions were hospitalizations for ACS conditions. The Afe of ACS hospitalizations was 46.57%, the PAF was 1.12%. Emergency service use for ACS conditions could be identified in 8.3% (3088) of all admissions (Afe: 79.57%, PAF: 5.08%). The odds ratio (OR) of asylum-seeking children being hospitalized for ACS conditions in comparison to the control group was 1.81 [95% confidence interval, CI: 1.02; 3.2]. The OR of the asylumseeking population compared to the general population for the utilization of emergency service use for ACS conditions was 4.93 [95% CI: 4.11; 5.91].   Conclusions Asylum-seeking children had significantly higher odds of ACS hospitalization and of utilization of emergency outpatient services for ACS conditions. Using the concept of ACS conditions allowed measuring the strength of primary care provided to this local asylum-seeking population. This approach could help to compare the strength of primary care provision in different locations, and allow an objective.
date: 2017
publisher: BioMed Central
id_scheme: DOI
id_number: http://dx.doi.org/10.1186/s12913-017-2672-7
ppn_swb: 1656273195
own_urn: urn:nbn:de:bsz:16-heidok-242493
language: eng
bibsort: LICHTLCELIDIFFERENCE2017
full_text_status: public
publication: BMC Health Services Research
volume: 17
number: 731
place_of_pub: London
pagerange: 1-9
issn: 1472-6963
citation:   Lichtl, Célina ; Lutz, Thomas ; Szecsenyi, Joachim ; Bozorgmehr, Kayvan  (2017) Differences in the prevalence of hospitalizations and utilization of emergency outpatient services for ambulatory care sensitive conditions between asylum-seeking children and children of the general population: a cross-sectional medical records study (2015).  BMC Health Services Research, 17 (731).  pp. 1-9.  ISSN 1472-6963     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/24249/1/12913_2017_Article_2672.pdf