Geographical Distribution of Avoidable Hospital Conditions in Romania

• Published in: Procedia environmental sciences 2016, Vol.32, p.318-326
• Main Authors: Ciutan, Marius, Scîntee, Silvia Gabriela, Dosius, Mihnea, Mototolea, Cristina, Vlădescu, Cristian
• Format: Article
• Language: English
• Subjects: avoidable hospital conditions; health disparities; Romania
• ISSN: 1878-0296; 1878-0296
• DOI: 10.1016/j.proenv.2016.03.037

Quality health indicators gained an essential place in attempting to achieve healthcare system performance. Generally, prevention is better and more efficient than cure. In this context, the current state of the art in measuring the outcomes of preventive and outpatient care through analysis of inpatient discharge data is represented by Preventive Quality Indicators that can flag potential problems resulting from a breakdown of health care services by tracking hospitalizations for conditions that should be treatable on an outpatient basis, or that could be less severe if treated early and appropriately. In practice, AHC is useful to identify the potentially preventable hospitalizations in different hospital units, but also the magnitude of preventable hospitalizations in different regions in order to compare the obtained values and thus to provide scientific evidence supporting decision making process. The objectives of the paper are to analyse disparities in potentially avoidable hospitalizations in Romania, in 2013, and to identify some determinants associated with a high level of this indicator. A cross-sectional study conducted on data provided by Romanian DRG database (data for hospital activity) and Romanian Institute of Statistics (data linked with resources availability) was carried out during the year 2013. All 472 public hospitals reporting data were included, regardless the type of hospital activity financing or type of pathology. Uni and bivariate analysis tried to correlate and describe the level of avoidable hospital morbidity by hospitals activity, demographic indicators and by coverage of population with medical personnel and medical units. AHCs valid hospital episodes and AHCs rates were calculated. Data were aggregated by region and district level; cartodiagrams were used for graphical analysis. In Romania, avoidable hospitalizations represent 7% of all hospitalizations. Over half of these hospitalizations have one of the following six diagnoses: primary hypertension (over 20%); hypertensive cardiomyopathy with congestive heart failure (6.3%); bacterial pneumonia, unknown (6%); non-infectious gastroenteritis and colitis, unspecified (5.5%); acute interstitial nephritis (4.6%) and type 2 diabetes mellitus with poor control (3.5%). District with the highest number of avoidable hospitalizations are among districts with medical university centres and those with larger population. High rates of avoidable hospitalizations were associated with h