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Ambulatory Care Sensitive Conditions Hospitalizations

This indicator measures the age-standardized acute care hospitalization rate for conditions where appropriate ambulatory care prevents or reduces the need for admission to hospital.

Low rates are desirable.

Data updated:
Data availability: to (fiscal years)
Geographic coverage
All provinces/territories
Reporting level
National, Province/Territory, Region, Neighbourhood Income Quintile
Calculation

(Total number of acute care hospitalizations for ambulatory care sensitive conditions in patients younger than age 75 ÷ total mid-year population younger than age 75) × 100,000 (age-adjusted)

Denominator

Total mid-year population younger than age 75

Numerator

Total number of acute care hospitalizations for ambulatory care sensitive conditions in patients younger than age 75

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Name

Ambulatory Care Sensitive Conditions Hospitalizations

Short/Other Names

Not applicable

Description

Age-standardized acute care hospitalization rate for conditions where appropriate ambulatory care prevents or reduces the need for admission to hospital, per 100,000 population younger than age 75.

For further details, please see the General Methodology Notes (PDF).

Rationale

Hospitalization for an ambulatory care sensitive condition is considered to be a measure of access to appropriate primary health care. While not all admissions for these conditions are avoidable, it is assumed that appropriate ambulatory care could prevent the onset of this type of illness or condition, control an acute episodic illness or condition, or manage a chronic disease or condition. A disproportionately high rate is presumed to reflect problems in obtaining access to appropriate primary care.

Interpretation

Low rates are desirable.

HSP Framework Dimension

ºìÁì½í¹Ï±¨ system outputs: Appropriate and effective

Areas of Need

Living With Illness, Disability or Reduced Function

Targets/Benchmarks

The appropriate level of hospitalization for these conditions is not known, and large regional variations in the rate of hospitalization for these conditions exist.

Available Data Years

to (fiscal years)

Geographic Coverage

  • All provinces/territories

Reporting Level/Disaggregation

  • National
  • Province/Territory
  • Region
  • Neighbourhood Income Quintile
  • Age group
  • Recorded sex or gender 
  • Urban versus rural/remote 
  • Ambulatory care sensitive condition category

Description

(Total number of acute care hospitalizations for ambulatory care sensitive conditions in patients younger than age 75 ÷ total mid-year population younger than age 75) × 100,000 (age-adjusted)

Type of Measurement

Rate - per 100,000

Denominator

Description:

Total mid-year population younger than age 75

Numerator

Description:

Total number of acute care hospitalizations for ambulatory care sensitive conditions in patients younger than age 75

Inclusions:

  1. Hospitalization for an ambulatory care sensitive condition is identified as any most responsible diagnosis code of 
    1. Grand mal status and other epileptic convulsions
      ICD-9/9-CM: 345
      ICD-10-CA: G40, G41 
    2. Chronic lower respiratory diseases (except asthma) 
      1. Any most responsible diagnosis (MRDx) code of
        ICD-9/9-CM: 491, 492, 494, 496
        ICD-10-CA: J41, J42, J43, J44, J47 
      2. MRDx of acute lower respiratory infection, only when a secondary diagnosis* of J44 in
        ICD-10-CA or 496 in ICD-9/9-CM is also present
        ICD-9/9-CM: 466, 480–486, 487.0
        ICD-10-CA: J10.0, J11.0, J12–J16, J18, J20, J21, J22
        *Secondary diagnosis refers to a diagnosis other than the most responsible one. 
    3. Asthma
      ICD-9/9-CM: 493
      ICD-10-CA: J45 
    4. Diabetes
      ICD-9: 250.0, 250.1, 250.2, 250.7
      ICD-9-CM: 250.0, 250.1, 250.2, 250.8
      ICD-10-CA: E10.0, E10.1, E10.63, E10.64, E10.9, E11.0, E11.1, E11.63, E11.64, E11.9, E13.0, E13.1, E13.63, E13.64, E13.9, E14.0, E14.1, E14.63, E14.64, E14.9 
    5. Heart failure and pulmonary edema†
      ICD-9/9-CM: 428, 518.4
      ICD-10-CA: J81 (MRDx), I50 (MRDx), I50 as diagnosis type (1) when I11 is MRDx
    6. Hypertension†
      ICD-9/9-CM: 401.0, 401.9, 402.0, 402.1, 402.9
      ICD-10-CA: I10 (MRDx), I11 as MRDx when I50 as diagnosis type (1) is not present
    7. Angina†
      ICD-9: 411, 413
      ICD-9-CM: 411.1, 411.8, 413
      ICD-10-CA: I20, I23.82, I24.0, I24.8, I24.9 

      † Excluding cases with cardiac procedures.
      List of cardiac procedure codes for exclusion:
      CCP: 47^^, 480^–483^, 489.1, 489.9, 492^–495^, 497^, 498^
      ICD-9-CM: 336, 35^^, 36^^, 373^, 375^, 377^, 378^, 379.4–379.8
      CCI: 1.HA.58.^^, 1.HA.80.^^, 1.HA.87.^^, 1.HB.53.^^, 1.HB.54.^^, 1.HB.55.^^, 1.HB.87.^^, 1.HD.53.^^, 1.HD.54.^^, 1.HD.55.^^, 1.HH.59.^^, 1.HH.71.^^, 1.HJ.76.^^, 1.HJ.82.^^, 1.HM.57.^^, 1.HM.78.^^, 1.HM.80.^^, 1.HN.71.^^, 1.HN.80.^^, 1.HN.87.^^, 1.HP.76.^^, 1.HP.78.^^, 1.HP.80.^^, 1.HP.82.^^, 1.HP.83.^^, 1.HP.87.^^, 1.HR.71.^^, 1.HR.80.^^, 1.HR.84.^^, 1.HR.87.^^, 1.HS.80.^^, 1.HS.90.^^, 1.HT.80.^^, 1.HT.89.^^, 1.HT.90.^^, 1.HU.80.^^, 1.HU.90.^^, 1.HV.80.^^, 1.HV.90.^^, 1.HW.78.^^, 1.HW.79.^^, 1.HX.71.^^, 1.HX.78.^^, 1.HX.79.^^, 1.HX.80.^^, 1.HX.83.^^, 1.HX.86.^^, 1.HX.87.^^, 1.HY.85.^^, 1.HZ.53 rubric (except 1.HZ.53.LA-KP), 1.HZ.54.^^, 1.HZ.55 rubric (except 1.HZ.55.LA-KP), 1.HZ.56.^^, 1.HZ.57.^^, 1.HZ.59.^^, 1.HZ.80.^^, 1.HZ.85.^^, 1.HZ.87.^^, 1.IF.83.^^, 1.IJ.50.^^, 1.IJ.54.GQ-AZ, 1.IJ.55.^^, 1.IJ.57.^^, 1.IJ.76.^^, 1.IJ.80.^^, 1.IJ.86.^^, 1.IK.50.^^, 1.IK.57.^^, 1.IK.80.^^, 1.IK.87.^^, 1.IN.84.^^, 1.LA.84.^^, 1.LC.84.^^, 1.LD.84.^^, 1.YY.54.LA-NJ, 1.YY.54.LA-FS, 1.YY.54.LA-NM, 1.YY.54.LA-FR, 1.YY.54.LA-FU

      Note:
      Code may be coded in any position. Procedures coded as abandoned after onset (Intervention Status Attribute = A) are excluded.
  2. Admission to an acute care institution (Facility Type Code = 1)
  3. Age at admission younger than 75
  4. Sex recorded as male or female

Exclusions:

  1. Records with discharge as death (Discharge Disposition Code = 07, 72*, 73*, 74*)
  2. Newborn, stillbirth or cadaveric donor records (Admission Category Code = N, R or S)

Note *
2018–2019 data onward.

Method of Adjustment

Direct standardization

Standard Population:
Canada 2011

Adjustment Applied

Age-adjusted

Geographic Assignment

Place of residence

Data Sources

  • DAD
  • HMDB

Caveats and Limitations

Not applicable

Trending Issues

Not applicable

Comments

This indicator is part of a set of common indicators to measure progress on the priority areas to improve health care announced by federal, provincial and territorial governments in 2023. Additional information is available on the Shared ºìÁì½í¹Ï±¨ Priorities web page. 

Indicator results are also available in .

References

Anderson GM. Common Conditions Considered Sensitive to Ambulatory Care. In Patterns of ºìÁì½í¹Ï±¨ Care in Ontario, 2nd Ed. Eds. V. Goel et al. Ottawa, ON: CMA; 1996: 104-110.

Billings J, Anderson GM, Newman LS. Recent Findings on Preventable Hospitalizations. ºìÁì½í¹Ï±¨ Aff (Millwood) 1996(15): 239-249.

Billings J, Zeitel L, Lukomnik J,et al. Impact of Socio-Economic Status on Hospital Use in New York City. ºìÁì½í¹Ï±¨ Aff (Millwood) 1993(12): 162-173.

Manitoba Centre for ºìÁì½í¹Ï±¨ Policy and Evaluation. Concept: Ambulatory Care Sensitive (ACS) Conditions. . Published September 26, 2007. Accessed August 21, 2024.

How to cite:

Canadian Institute for ºìÁì½í¹Ï±¨ Information. Ambulatory Care Sensitive Conditions Hospitalizations. Accessed January 1, 2025.

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