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

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.