Ambulant-sensitive Krankenhausfälle: Eine inter­nationale Übersicht mit Schlussfolgerungen für einen deutschen Katalog

Zusammenfassung

Ziel der Studie: Ambulant-sensitive Krankenhausfälle (ASK) dienen der Qualitätsmessung im ambulanten Sektor. Ziel dieses Reviews ist es, einen Überblick über existierende ASK-Kataloge zu erstellen und daraus Erkenntnisse für die geplante Ausarbeitung eines Katalogs für Deutschland abzuleiten.

Methodik: Dieser Artikel nimmt eine Systematisierung der Diskussion zu ASK vor, indem der ­Begriff von den verwandten Themen der vermeidbaren Krankenhausfälle und vermeidbaren Krankheiten abgegrenzt wird. Auf Grundlage dieser Systematisierung werden eine für den deutschen Kontext gültige Definition des ASK-Begriffs entwickelt, eine Empfehlung für die Zusammenstellung adäquater Diagnosen gegeben sowie Anwendungsbereiche eines für Deutschland spezifischen ASK-Katalogs vorgeschlagen. Ein tabellarischer Überblick über neun zentrale Artikel, die die Ausarbeitung von ASK-Katalogen in anderen Ländern beschreiben, sowie ein erster Überblick über die darin enthaltenen Diagnosen dienen dabei als zentraler Leitfaden.

Ergebnisse und Schlussfolgerung: Die Erstellung eines für den deutschen Kontext angepassten ASK-Katalogs ist notwendig, um den lokalen Gegebenheiten des deutschen Gesundheitssystems Rechnung zu tragen und so die Validität des Qualitätsindikators sicherzustellen. Ein solcher Ergebnisindikator für den ambulanten Sektor kann einen Schritt hin zu einer stärker ergebnis­orientierten Versorgung bedeuten und helfen, die Qualität im Gesundheitswesen sicher zu stellen.

Abstract

Objective: Ambulatory care-sensitive conditions (ACSC) foster to quality measurement in the ambulatory sector. The objective of this review is to provide an overview of existing catalogues of ACSC and to derive insights that support the plan­ned development of an ACSC catalogue for Germany.

Methods: This article attempts to systemise the discussion on ACSC by delimiting the term from the related concepts of avoidable hospitalisations and avoidable diseases. Based on that, this article develops a definition of ACSC that is valid for the German context, makes a suggestion for the compilation of adequate diagnoses, and proposes how to apply an ACSC catalogue that is specific to Germany. An overview of nine central ­articles describing the elaboration of ACSC catalogues in other countries and a first view of the diagnoses they comprise serve as a guidance.

Results and Conclusion: The composition of an ACSC catalogue, that is adapted to the German context, is required to account for the local specifics of the German health-care system in order to ensure validity of the quality indicator. Such an outcome indicator for the ambulatory sector may mean a step towards a more outcome-oriented provision of care and may help ensure the quality of the German health-care system.

Schlüsselwörter

ambulant-sensitive ­Krankenhausfälle (ASK) - vermeidbare ­Krankenhausfälle - Qualität der ambulanten Versorgung - Literaturüberblick - Deutschland

Keywords

ambulatory care-sensitive conditions (ACSC) - avoidable hospitalization - quality of ambulatory care - literature review - Germany

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