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Health Aff (Millwood). 2017 Nov;36(11):1896-1903. doi: 10.1377/hlthaff.2017.0479.

Avoidable Hospital Admissions From Diabetes Complications In Japan, Singapore, Hong Kong, And Communities Outside Beijing.

Author information

1
Jianchao Quan ( jquan@hku.hk ) is a clinical assistant professor in the Division of Health Economics, Policy, and Management, School of Public Health, University of Hong Kong, in China.
2
Huyang Zhang is a PhD student in the China Center for Health Development Studies at Peking University, Beijing, in China.
3
Deanette Pang is a research analyst in the Policy, Research, and Evaluation Division in the Singapore Ministry of Health.
4
Brian K. Chen is an associate professor in the Arnold School of Public Health, University of South Carolina, in Columbia.
5
Janice M. Johnston is an associate professor in the Division of Health Economics, Policy, and Management, School of Public Health, University of Hong Kong.
6
Weiyan Jian is an associate professor in the Department of Health Policy and Administration, School of Public Health, Peking University.
7
Zheng Yi Lau is the assistant director of the Policy, Research, and Evaluation Division in the Singapore Ministry of Health.
8
Toshiaki Iizuka is a professor in the Graduate School of Economics, University of Tokyo, in Japan.
9
Gabriel M. Leung is a professor in the Division of Health Economics, Policy, and Management, School of Public Health, University of Hong Kong.
10
Hai Fang is a professor in the China Center for Health Development Studies at Peking University.
11
Kelvin B. Tan is the director of the Policy, Research, and Evaluation Division in the Singapore Ministry of Health, and an adjunct assistant professor at Saw Swee Hock School of Public Health, National University of Singapore.
12
Karen Eggleston is a senior fellow at the Freeman Spogli Institute for International Studies (FSI) and deputy director of the FSI's Shorenstein Asia-Pacific Research Center, both at Stanford University, in California; and a faculty research fellow at the National Bureau of Economic Research, in Cambridge, Massachusetts.

Abstract

Improving the quality of primary care may reduce avoidable hospital admissions. Avoidable admissions for conditions such as diabetes are used as a quality metric in the Health Care Quality Indicators of the Organization for Economic Cooperation and Development (OECD). Using the OECD indicators, we compared avoidable admission rates and spending for diabetes-related complications in Japan, Singapore, Hong Kong, and rural and peri-urban Beijing, China, in the period 2008-14. We found that spending on diabetes-related avoidable hospital admissions was substantial and increased from 2006 to 2014. Annual medical expenditures for people with an avoidable admission were six to twenty times those for people without an avoidable admission. In all of our study sites, when we controlled for severity, we found that people with more outpatient visits in a given year were less likely to experience an avoidable admission in the following year, which implies that primary care management of diabetes has the potential to improve quality and achieve cost savings. Effective policies to reduce avoidable admissions merit investigation.

KEYWORDS:

Cost of Health Care; Health Economics; Health Spending; International/global health studies; Variations

PMID:
29137504
DOI:
10.1377/hlthaff.2017.0479
[Indexed for MEDLINE]

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