Estimates of potentially preventable hospitalizations in diseases ambulatory care subjected to in Ukraine

The purpose: this study aims to identify the most relevant diseases that can be treated outpatient (Ambulatory Care Sensitive Conditions, or ACSCs) and to define the scope of potentially preventable hospitalizations (PPHs) for such conditions (Ambulatory Care Sensitive Hospitalizations, or ACSH), for Ukrainian adults (above 18 years old), subject to improvement of primary care efficiency. The study has been carried out in four phases, using the World Health Organization's (WHO) guidance on ACSCs for the European Region, which was adapted to the national context. The data was taken from the official statistical reporting and analyzed by 104 reviewers. The assessment of the PPHs is conducted based on responses of the subgroup of reviewers – 6 experts and 61 primary care physicians, which confirmed the levels of competencies. The most significant rates of potentially preventable hospitalizations (PPHs) are registered for hypertension, pneumonia, angina, chronic obstructive pulmonary disease (COPD), and diabetes, which coincide with ACSCs that are most prevalent for Ukrainian adults. The overall rate of PPHs for adult population of Ukraine with ACSCs is 28.2% as defined by physicians and 32.9% as defined by experts, which may reduce the hospitalization rate for all ACSCs (as percent of all patients with ACSCs) from 8.2% to 6.1% (according to reviews of physicians) or to 5.7% (according to experts' reviews). The study has shown an important scope for better managing of ACSCs in Ukrainian adults. The results of the study can be used to inform the continued health system transformation, specifically for the development of interventions to prevent avoidable hospitalizations for ACSCs in Ukraine, which can lead to more efficient use of resources in the health system and further strengthening of the primary care.