Preventable hospitalizations from ambulatory care sensitive conditions in nursing homes: evidence from Switzerland

Int J Public Health. 2019 Dec;64(9):1273-1281. doi: 10.1007/s00038-019-01294-1. Epub 2019 Sep 3.


Objectives: Reducing nursing home hospitalizations for ambulatory care sensitive conditions (ACSC) has been identified as an opportunity to improve patient well-being and reduce costs. The aim of this study was to identify number of hospitalizations for ACSCs for nursing home residents in a Swiss national sample, examine demographic characteristics of nursing home hospitalizations due to ACSCs, and calculate hospital expenses from these hospitalizations.

Methods: Using merged hospital administrative data with payment data based on diagnosis-related groups (DRGs) for the year 2013, we descriptively examined nursing home residents who were 65 years of age or older and were admitted to an acute care hospital.

Results: Approximately 42% of all nursing home admissions were due to ACSCs. Payments to Swiss hospitals for ACSCs can be estimated at between 89 and 105 million Swiss francs in 2013.

Conclusions: A sizable share of hospitalizations for nursing home residents is for ACSCs, and the associated costs are substantial. Programs and policies designed to reduce these potentially avoidable hospitalizations from the nursing home setting could lead to an increased patient well-being and lower costs.

Keywords: Avoidable hospitalizations; Hospital costs; Nursing homes; Preventable hospitalizations.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Ambulatory Care / economics*
  • Ambulatory Care / statistics & numerical data*
  • Cost Savings / statistics & numerical data*
  • Costs and Cost Analysis
  • Female
  • Hospitalization / economics*
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Nursing Homes / economics*
  • Nursing Homes / statistics & numerical data*
  • Switzerland