Impact of Integrated Care on the Rate of Hospitalization for Ambulatory Care Sensitive Conditions among Older Adults in Stockholm County: An Interrupted Time Series Analysis

Introduction: Reducing avoidable hospital admissions is often viewed as a possible positive consequence of introducing integrated care (IC). The aim of this study was to investigate the impact of implementing IC in Norrtälje on the rate of admissions for ambulatory care sensitive conditions (ACSC)....

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Main Authors: Janne Agerholm, Antonio Ponce de Leon, Pär Schön, Bo Burström
Format: Article
Language:English
Published: Ubiquity Press 2021-06-01
Series:International Journal of Integrated Care
Subjects:
Online Access:https://www.ijic.org/articles/5505
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spelling doaj-d3cd1191a313408598ce6f50f49a136d2021-07-14T06:18:53ZengUbiquity PressInternational Journal of Integrated Care1568-41562021-06-0121210.5334/ijic.55055139Impact of Integrated Care on the Rate of Hospitalization for Ambulatory Care Sensitive Conditions among Older Adults in Stockholm County: An Interrupted Time Series AnalysisJanne Agerholm0Antonio Ponce de Leon1Pär Schön2Bo Burström3Aging Research Center, Karolinska Institutet, StockholmCenter for epidemiology and community medicine, Stockholm, County CouncilAging Research Center, Karolinska Institutet, StockholmDepartment of Public Health Sciences, Karolinska Institutet, Stockholm; Center for epidemiology and community medicine, Stockholm, County CouncilIntroduction: Reducing avoidable hospital admissions is often viewed as a possible positive consequence of introducing integrated care (IC). The aim of this study was to investigate the impact of implementing IC in Norrtälje on the rate of admissions for ambulatory care sensitive conditions (ACSC). Method: Using interrupted time series analyses we investigated the effect of implementing IC in Norrtälje municipality in the northern part of Stockholm county, Sweden. The time period included 48 time points, from year 2000 to year 2011 with measurements before and after introducing IC in Norrtälje in 2006. In order to control for other extraneous events that could affect the outcome measure, but not related to the introduction of IC, we included a control population from Stockholm municipality. Results: After introducing IC in Norrtälje the rate of admissions for ACSC decreased. This decrease was greater in Norrtälje than in the matched control population, however the difference between the two areas was not statistically significant (p = 0.08). Conclusion: Introducing IC in Norrtälje may have had positive impact on admissions for ACSC for older people living in Norrtälje; however, the interpretation of the impact of IC on admissions for ACSC is complicated by intervening policy changes in health and social care during the study period.https://www.ijic.org/articles/5505integrated careswedenambulatory care sensitive conditionstime seriesaginghealth care
collection DOAJ
language English
format Article
sources DOAJ
author Janne Agerholm
Antonio Ponce de Leon
Pär Schön
Bo Burström
spellingShingle Janne Agerholm
Antonio Ponce de Leon
Pär Schön
Bo Burström
Impact of Integrated Care on the Rate of Hospitalization for Ambulatory Care Sensitive Conditions among Older Adults in Stockholm County: An Interrupted Time Series Analysis
International Journal of Integrated Care
integrated care
sweden
ambulatory care sensitive conditions
time series
aging
health care
author_facet Janne Agerholm
Antonio Ponce de Leon
Pär Schön
Bo Burström
author_sort Janne Agerholm
title Impact of Integrated Care on the Rate of Hospitalization for Ambulatory Care Sensitive Conditions among Older Adults in Stockholm County: An Interrupted Time Series Analysis
title_short Impact of Integrated Care on the Rate of Hospitalization for Ambulatory Care Sensitive Conditions among Older Adults in Stockholm County: An Interrupted Time Series Analysis
title_full Impact of Integrated Care on the Rate of Hospitalization for Ambulatory Care Sensitive Conditions among Older Adults in Stockholm County: An Interrupted Time Series Analysis
title_fullStr Impact of Integrated Care on the Rate of Hospitalization for Ambulatory Care Sensitive Conditions among Older Adults in Stockholm County: An Interrupted Time Series Analysis
title_full_unstemmed Impact of Integrated Care on the Rate of Hospitalization for Ambulatory Care Sensitive Conditions among Older Adults in Stockholm County: An Interrupted Time Series Analysis
title_sort impact of integrated care on the rate of hospitalization for ambulatory care sensitive conditions among older adults in stockholm county: an interrupted time series analysis
publisher Ubiquity Press
series International Journal of Integrated Care
issn 1568-4156
publishDate 2021-06-01
description Introduction: Reducing avoidable hospital admissions is often viewed as a possible positive consequence of introducing integrated care (IC). The aim of this study was to investigate the impact of implementing IC in Norrtälje on the rate of admissions for ambulatory care sensitive conditions (ACSC). Method: Using interrupted time series analyses we investigated the effect of implementing IC in Norrtälje municipality in the northern part of Stockholm county, Sweden. The time period included 48 time points, from year 2000 to year 2011 with measurements before and after introducing IC in Norrtälje in 2006. In order to control for other extraneous events that could affect the outcome measure, but not related to the introduction of IC, we included a control population from Stockholm municipality. Results: After introducing IC in Norrtälje the rate of admissions for ACSC decreased. This decrease was greater in Norrtälje than in the matched control population, however the difference between the two areas was not statistically significant (p = 0.08). Conclusion: Introducing IC in Norrtälje may have had positive impact on admissions for ACSC for older people living in Norrtälje; however, the interpretation of the impact of IC on admissions for ACSC is complicated by intervening policy changes in health and social care during the study period.
topic integrated care
sweden
ambulatory care sensitive conditions
time series
aging
health care
url https://www.ijic.org/articles/5505
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