Complex community health and social care interventions – Which features lead to reductions in hospitalizations for ambulatory care sensitive conditions? A systematic literature review. Issue 12 (December 2022)

• Record Type: Journal Article
• Authors: Duminy, Lize; Ress, Vanessa; Wild, Eva-Maria
• Is Part Of: Health policy. Volume 126:Issue 12(2022)
• Page Start: 1206
• Page End: 1225
• Publication Date: 2022-12
• Subjects: Ambulatory care sensitive condition -- Community health services -- Social care -- Systematic literature review -- Intervention features; ACSCs Ambulatory Care Sensitive Conditions; Medical education -- Periodicals; Medical policy -- Periodicals; Delivery of Health Care -- Periodicals; Education, Medical -- Periodicals; Health Education -- Periodicals; Health Planning -- Periodicals; Public Policy -- Periodicals; Enseignement médical -- Périodiques; Politique sanitaire -- Périodiques; Medical education; Medical policy; Periodicals; Electronic journals; Electronic journals; 362.1
• DOI: 10.1016/j.healthpol.2022.10.003
• Languages: English
• ISSNs: 0168-8510

Abstract

Highlights: We systematically reviewed interventions including/consisting of community health services and social care. Outcome of interest was the hospitalization rate for ambulatory care sensitive conditions. The structural feature shared by all successful interventions was physician involvement. The behavioral feature shared by all successful interventions was care management. Abstract: Preventing hospitalizations due to ambulatory care sensitive conditions (ACSCs) is traditionally the responsibility of primary care. The determinants of ACSC hospitalizations, however, are not purely medical, but also influenced by other factors like patients' social and personal circumstances. Interventions that include or consist entirely of community health services and social care could potentially reduce the ACSC hospitalization rate. Comparisons of the features of successful interventions of this nature, however, are still lacking. We therefore conducted a systematic review of the literature to identify out-of-hospital interventions that (a) included aspects or consisted entirely of community health services and social care and (b) analyzed the ACSC hospitalization rate as an outcome measure. We identified papers reporting the results of 32 interventions and extracted structural and behavioral features to determine which of these were shared by most or all of the successful interventions. We found that all of the successful interventions included a primary care physician and provided care management. Moreover, most of the successful interventions were characterized by a high degree of interconnectedness between professional groups and provided care within so-called health care homes. We also identified a set of care coordination activities that were implemented in most of the successful interventions. Policy makers may wish to consider adopting these features when designing interventions that aim to reduce the ACSC hospitalization rate. Graphical abstract: Image, graphical abstract