Variation in hospital discharges for ambulatory care-sensitive conditions among children

Objective. Ambulatory Care-Sensitive Conditions (ACSCs), conditions for whi ch ambulatory care may reduce, though not eliminate, the need for hospital admission, have been used as an index of adequate primary care. However, fe w studies of ACSC have focused on children. We estimated national hospitali zation rates for ACSC among children and examined the behavior of the index between subgroups of children. Methods. We used data from the 1990-1995 National Hospital Discharge Survey s (NHDS), the US census, and the National Health Interview Survey (NHIS) to calculate hospital discharge rates. Rates were estimated as the number of condition-specific hospital discharges from the NHDS divided by the populat ion at risk, as estimated from the US census and NHIS. Results. Predictably, ACSC hospitalization rates were significantly higher among children who were younger, black, had Medicaid insurance, and lived i n poorer areas compared with their counterparts. However, the relationship between ACSCs and income and the distributions of conditions within the ind ex varied significantly between children. Conclusions. ACSCs may indicate disparities in access and utilization of he alth care, however, the differing behavior of the index between subgroups s uggests that inferences from examining rates of ACSCs may not be comparable for all children.