Hospitalization for Ambulatory Care Sensitive Conditions: Concept, Identification and Policy Implications

The accessibility and quality of ambulatory care (including outpatient and emergency services in primary care facilities, hospitals and other healthcare facilities) determine the efficiency of overall health care system and population health. Ambulatory care is also the core component of continuing care in an aging society. The concept of ambulatory care sensitive conditions (ACSCs) was firstly introduced by American researchers in 1990s. Since then, hospitalization for ambulatory care sensitive conditions (ACSHs) was widely used to evaluate the accessibility and quality of ambulatory care. In recent years, research on ACSH has gradually attracted the attention of scholars from all over the world, and preliminary research evidence from China indicated that the issue should not be ignored. This paper firstly introduces the origin of the concept of ACSH, then identifies the mixing concepts such as ACSH, avoidable hospitalization and inappropriate hospital admission, systematically summarizes the cutting-edge international identification criteria of ACSH, and finally discusses the policy value of ACSH as an indicator in the context of domestic and international research advances, clarifies the problems that should be noted in the identification of ACSCs in China, proposes strategies to reduce ACSH.