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Defining chronic ambulatory care sensitive conditions in Malaysia: a collaborative consensus study.

Shakirah Md Sharif1, Weng Hong Fun2, Suresh Kumar Chidambaram3

  • 1Centre for Health Outcomes Research, Institute for Health Systems Research, Shah Alam, Selangor, Malaysia shakirah.ms@moh.gov.my.

BMJ Open
|January 12, 2026
PubMed
Summary

Ten chronic ambulatory care sensitive conditions (ACSCs) were identified in Malaysia. These conditions accounted for 8.6% of preventable hospitalizations in Ministry of Health facilities, highlighting areas for improved outpatient care.

Keywords:
Chronic DiseaseDelphi TechniqueHospitalizationPrimary Health Care

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Area of Science:

  • Public Health
  • Healthcare Management
  • Preventive Medicine

Background:

  • Ambulatory Care Sensitive Conditions (ACSCs) are indicators of outpatient care quality.
  • Preventable hospitalizations represent a significant burden on healthcare systems.
  • Understanding context-specific ACSCs is crucial for effective health policy.

Purpose of the Study:

  • To develop a list of chronic Ambulatory Care Sensitive Conditions (ACSCs) relevant to Malaysia.
  • To identify potentially preventable hospitalizations in Malaysian Ministry of Health (MOH) facilities using this list.

Main Methods:

  • A multi-panel modified Delphi approach involving 42 experts.
  • Secondary analysis of inpatient data from MOH hospitals (2022).
  • Consultative panel discussions to refine the ACSC list.

Main Results:

  • Ten chronic ACSCs were identified for Malaysia: angina, asthma, chronic kidney disease, convulsions and epilepsy, chronic obstructive pulmonary disease, diabetes mellitus, heart failure, hypertension, iron deficiency anaemia, and ischaemic heart disease.
  • These 10 conditions constituted 8.6% of all potentially preventable hospitalizations in MOH facilities in 2022.
  • The study established a baseline for monitoring preventable hospitalizations due to chronic conditions.

Conclusions:

  • A context-specific list of chronic ACSCs for Malaysia has been established.
  • Findings indicate a substantial proportion of hospital admissions could be reduced by enhancing outpatient care.
  • The identified ACSCs serve as targets for policy interventions to optimize primary care and decrease hospitalizations.