Related Experiment Video
Updated: Jan 7, 2026
A Modified Sonographic Algorithm for Image Acquisition in Life-Threatening Emergencies in the Critically Ill Newborn
Published on: April 7, 2023
Avoidable hospitalizations for ambulatory care sensitive conditions in children under five years in Ecuador,
Carolina Buñay-Morocho1, Pablo Álvarez1, Daniel Zurita1
1Universidad Internacional del Ecuador, Quito, Ecuador.
Insights
Avoidable hospitalizations for ambulatory care sensitive conditions (ACSCs) in children under five increased overall, with significant rises in respiratory and skin infections. Projections show ACSCs will remain a substantial proportion of discharges, highlighting primary care needs.
Area of Science:
- Public Health
- Health Services Research
- Pediatric Health
Background:
- Ambulatory care sensitive conditions (ACSCs) serve as key indicators of primary healthcare quality and care coordination effectiveness.
- Understanding trends in pediatric ACSC hospitalizations is crucial for assessing and improving health system performance.
Purpose of the Study:
- To analyze the proportion and trends of hospital discharges for ACSCs in children under five years old in Ecuador from 2000 to 2023.
- To project future ACSC hospitalization rates through 2026.
- To compare standardized ACSC hospitalization rates across different cantons.
Main Methods:
- Ecologic time-series analysis of national hospital discharge data (2000-2023) for 20 defined ACSCs.
- Joinpoint regression for estimating annual percentage changes and Prophet package for forecasting.
- Standardized morbidity ratios (SMRs) calculated using census data (2001, 2010, 2022) to compare cantonal rates.
Main Results:
- ACSCs constituted 26.6% of all pediatric hospital discharges between 2000 and 2023.
- Overall ACSC rates increased by 2% annually, with significant increases in respiratory diseases (6.8%), urinary infections (6.4%), and skin infections (4.2%). Gastrointestinal diseases decreased by 1.9% annually.
- Projections indicate ACSCs may account for 20.3% of discharges by 2026. Over 5% of cantons consistently showed higher-than-expected SMRs.
Conclusions:
- Rising ACSC rates, particularly in the early 2000s, correlate with economic factors and healthcare investment levels.
- The observed decline during the COVID-19 pandemic warrants further investigation.
- Strengthening primary healthcare services and public health planning is essential to reduce avoidable pediatric hospitalizations.
Abstract:
Avoidable hospitalizations due to ambulatory care sensitive conditions (ACSC) are an indirect indicator of primary health care quality and effectiveness of care coordination. This study aims to analyze the proportion and trends of hospital discharges for ACSCs (2000-2023) among children under five years, project rates through 2026, and compare standardized rates across cantons. We conducted an ecologic time-series analysis using Ecuador's national hospital discharge data for 20 ACSCs, as defined by the Pan-American Health Organization. Annual percentage changes were estimated using Joinpoint regression, and forecasts were generated with the Prophet package in R. Standardized morbidity ratios (SMRs) were used to compare rates across 221 cantons, based on Ecuador's population from the 2001, 2010, and 2022 censuses. Between 2000 and 2023, ACSCs accounted for 26.6% of all hospital discharges. The overall average of annual percent change increased by 2%, and by 6.8%, 6.4%, and 4.2% for respiratory diseases, urinary and skin infections, respectively. Gastrointestinal diseases declined by 1.9% annually. Significant changes in ACSC trends were observed during the following periods: 2000-2007; 2018-2021; and 2021-2023. No significant change occurred from 2008 to 2018. Projections indicated that ACSCs may still represent 20.3% of hospital discharges by 2026. Moreover, 5.4% of cantons consistently exceeded expected SMRs across all three census years analyzed. The rising ACSC rates during the early 2000s, marked by economic structural adjustment and limited public healthcare investment, contrasts with the decline observed during the COVID-19 pandemic. These findings underscore the need to strengthen primary care and public health planning.
More Related Videos
Related Concept Videos
01:30Preventive Healthcare Services
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:26Methods Of Healthcare Delivery System
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
01:26Pharmacokinetics in Pediatric Patients: Drug Excretion
01:17Pharmacokinetics in Pediatric Patients: Drug Distribution
01:30Primary Healthcare Services
In 1978, international leaders convened in Alma-Ata, Kazakhstan, for what would be a pivotal event in global health. The Alma-Ata Declaration was the first to call...