A systematic review of the magnitude and cause of geographic variation in unplanned hospital admission rates and length of stay for ambulatory care sensitive conditions

Busby, John; Purdy, Sarah; Hollingworth, William

doi:10.1186/s12913-015-0964-3

Table 1 Study details, admission rates

From: A systematic review of the magnitude and cause of geographic variation in unplanned hospital admission rates and length of stay for ambulatory care sensitive conditions

Paper ID	Condition	Number of Admissions	Geographical Units (N) ^a	Mean Age (SD)^b	Covariate Adjustment^c	Statistical Methods	Tested Cause	Untested Cause
Australia
Ansari 2005 [56]	Diabetes	38,900	Primary Care Partnerhips (32)	N/A	A,S	Raw Data	None	Case Mix
						Graphs		SC Access
								SC Quality
								Clinical Guidelines
								Coding Quality
Tennant 2000 [57]	Dental	3,754	Health service region (32)	<18 (100 %)	A	Raw Data	None	None
Tennant 2000 [57]	Dental	3,754	Health service region (32)	<18 (100 %)	A	Graphs	None	None
Canada
Crighton 2007 [58]	Influenza	241,803	County (49)	N/A	A,S	Raw Data	None	Case Mix
	Pneumonia					Maps		SC Access
						Spatial Analysis		PC Quality
						Range Analysis		Clinical Guidelines
						COV		Clinical Guidelines
Crighton 2008 [59]	Influenza	241,803	County (49)	N/A	A,S	Raw Data	None	Case Mix
						Maps		Case Mix
								Coding Quality
	Pneumonia
	Pneumonia					Spatial Analysis
Curtis 2002 [60]	Diabetes	15,872	District Health Board (16)	<18 (100 %)	A,S	Raw Data	None	Case Mix
						Maps		Case Mix
						Maps		PC Quality
						Extremal Quotient		PC Quality
Jin 2003 [25]	Pneumonia	36,516	Health Region (17)	18-44 (18 %)	A,S	Raw Data	SC Access	Case Mix
				46-64 (19 %)		Graphs
				65-74 (20 %)
				75-84 (26 %)
				85+ (16 %)
To 1996 [24]	Gastroenteritis	10,105	County (41)	<1 (25.3 %)	A,S	Range	Case Mix	Coding Quality
				1 (25.7 %)		COV	SC Access
				2 (14.5 %)		SCV
				3-5 (17.3 %)		Extremal Quotient
				6-8 (7.0 %)
				9-14 (4.4 %)
				12-14 (2.9 %)
				15-17 (2.8 %)
New Zealand
Bandaranayake 2011 [61]	Influenza	1,743	District Health Board (20)	N/A	None	Raw Data	None	Case Mix
Bandaranayake 2011 [61]	Influenza	1,743	District Health Board (20)	N/A	None	Graphs	None	Case Mix
Barnett 2010 [26]	ACSCs	24,894	GP Practice (102)	N/A	None	Raw Data	Case Mix	None
						Graphs	PC Quality
							PC Access
							Practice Size
Dharmalingam 2004 [62]	ACSCs	N/A	Modified District Health Board (29)	N/A	A	Raw Data	Case Mix	None
Dharmalingam 2004 [62]	ACSCs	N/A	Modified District Health Board (29)	N/A	A	Tables	Case Mix	None
Ellison-Loschmann 2004 [53]	Asthma	25,865	Territorial Authority (74)	N/A	None	Raw Data	None	Case Mix
Ellison-Loschmann 2004 [53]	Asthma	25,865	Territorial Authority (74)	N/A	None	Maps	None	Case Mix
Spain
Magan 2008 [63]	ACSCs	64,409	Health District (34)	78.9	A,S	Raw Data	Case Mix	PC Quality
	Cardiovascular Disease					Maps		Clinical Guidelines
	Heart Failure					Tables		Staffing Levels
	Pneumonia					Range
						COV
						SCV
UK
Downing 2007 [20]	Asthma	2,271	GP Practice (94)	<65 (84.8 %)	A,S,O	Hierarchical Model	Case Mix	None
	Cardiovascular Disease			>65 (15.2 %)		Variance Estimates	PC Quality
	COPD
	Diabetes
	Stroke
Giuffrida 1999 [22]	Asthma	N/A	Health Authority (90)	N/A	None	Range	Case Mix	Clinical Guidelines
	Diabetes						SC Access
							Staffing Levels
Starr 1996 [56]	Stroke	N/A	Local government districts (22)	40-59 (100 %)	None	Raw Data	Case Mix	SC Access
						Tables
US
Adams 1993 [64]	Alcohol Abuse	87,147	State (50)	>65 (100 %)	A,S,O	Raw Data	Case Mix	Coding Quality
Adams 1993 [64]	Alcohol Abuse	87,147	State (50)	>65 (100 %)	A,S,O	Maps	Case Mix	Coding Quality
Casper 2010 [65]	Heart Failure	N/A	County (3,187)	>65 (100 %)	A	Raw Data	None	Coding Quality
Casper 2010 [65]	Heart Failure	N/A	County (3,187)	>65 (100 %)	A	Maps	None	PC Access
Chen 2011 [19]	Heart Failure	55,097,390	State (52)	79.0 (7.7)	A,S,C,O	Raw Data	None	None
Chen 2011 [19]	Heart Failure	55,097,390	State (52)	79.0 (7.7)	A,S,C,O	Maps	None	None
Gorton 2006 [66]	Pneumonia	4,948	County (67)	59.6 mo	A,S,O	Raw Data	None	Case Mix
Gorton 2006 [66]	Pneumonia	4,948	County (67)	59.6 mo	A,S,O	Maps	None	SC Access
Holt 2011 [67]	COPD	3,786,908	State (50)	>65 (100 %)	None	Raw Data	None	Case Mix
			Hospital Referral Region (949)			Maps
						Spatial Analysis
Laditka 1999 [68]	ACSCs	21,923	Hospital Market Area (24)	>65 (100 %)	A,S	Raw Data	None	Case Mix
Laditka 1999 [68]	ACSCs	21,923	Hospital Market Area (24)	>65 (100 %)	A,S	Tables	None	PC Access
Lanska 1994 [69]	Stroke	318,000	State (49)	>65 (100 %)	A,S,O	Raw Data	None	Case Mix
						Maps		SC Access
						Spatial Analysis		SC Access
								Clinical Guidelines
								Procedure/Drug
								Availability
								High readmission rates
Maliszewski 2011 [60]	Influenza	2,010	County (58)	<18 (24.4 %)	A,S,O	Raw Data	Case Mix	None
				>65 (12.4 %)		Maps
				>65 (12.4 %)		Spatial Analysis
Morris 1994 [23]	Asthma	N/A	County (3,079)	>65 (100 %)	A,S,O	Raw Data	Case Mix	Coding Quality
	COPD					Maps	SC Access
	Pneumonia					Spatial Analysis	Staffing Levels
Ogunniyi 2012 [70]	Heart Failure	845,421	County (1,014)	65-75 (30.8 %)	A	Raw Data	None	Case Mix
			State (10)	75-84 (41.3 %)		Tables		SC Access
				>85 (27.9 %)		Maps		PC Access
				>85 (27.9 %)		Spatial Analysis		PC Access

^aNumber of geographical units
^bMean age and standard deviation when available. Other counts represent percentage of patients in each age band
^cA: Age, S: Sex, C: Case-Mix, O: Other
^dPrimary Care
^eSecondary Care

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