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<div id="summaryView" role="tabpanel" aria-labelledby="tabSummaryView">
HTML Table
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Name
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<tr><td>Name</td><td>

Ambulatory Care Sensitive Conditions

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Short/Other Names
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</td></tr>

<tr><td>Short/Other Names</td><td>

Not applicable

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Description
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<tr><td>Description</td><td>

Age-standardized acute care hospitalization rate for conditions where appropriate ambulatory care prevents or reduces the need for admission to hospital, per 100,000 population younger than age 75.

For further details, please see the General Methodology Notes (PDF).

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Interpretation
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<tr><td>Interpretation</td><td>

Low rates are desirable.

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HSP Framework Dimension
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<tr><td>HSP Framework Dimension</td><td>

Health System Outputs: Appropriate and effective

Table Row (tr)
Table Cell (td)
Areas of Need
Table Cell (td) HTML

</td></tr>

<tr><td>Areas of Need</td><td>

Living With Illness, Disability or Reduced Function

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Geographic Coverage
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<tr><td>Geographic Coverage</td><td>

All provinces/territories

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Reporting Level/Disaggregation
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<tr><td>Reporting Level/Disaggregation</td><td>

National, Province/Territory, Region, Neighbourhood Income Quintile

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Indicator Results
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<tr><td>Indicator Results</td><td>

Accessing Indicator Results on Your Health System: In Depth

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</table>

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<div role="button" class="expandableTitle" aria-controls="identifyingInfoRegion">Identifying Information</div>
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<tr><td>Name</td><td>

Ambulatory Care Sensitive Conditions

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Short/Other Names
td HTML
</td></tr>

<tr><td>Short/Other Names</td><td>

Not applicable

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<div role="button" class="expandableTitle" aria-controls="descAndCalRegion">Indicator Description and Calculation</div>

<table 
HTML Table
id
descAndCalRegion
Table Row (tr)
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Description
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="descAndCalRegion">

<tr><td>Description</td><td>

Age-standardized acute care hospitalization rate for conditions where appropriate ambulatory care prevents or reduces the need for admission to hospital, per 100,000 population younger than age 75.

For further details, please see the General Methodology Notes (PDF).

Table Row (tr)
Table Cell (td)
Calculation: Description
td HTML
</td></tr>

<tr><td>Calculation: Description</td><td>

(Total number of acute care hospitalizations for ambulatory care sensitive conditions in patients younger than age 75 ÷ total mid-year population younger than age 75) × 100,000 (age-adjusted)

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Calculation: Geographic Assignment
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<tr><td>Calculation: Geographic Assignment</td><td>

Place of residence

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Calculation: Type of Measurement
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<tr><td>Calculation: Type of Measurement</td><td>

Rate - per 100,000

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Calculation: Adjustment Applied
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<tr><td>Calculation:  Adjustment Applied</td><td>

Age-adjusted

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Calculation: Method of Adjustment
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<tr><td>Calculation:  Method of Adjustment</td><td>

Direct Standardization
Standard Population:
Canada 2011

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Denominator
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<tr><td>Denominator</td><td>

Description:
Total mid-year population younger than age 75

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Numerator
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<tr><td>Numerator</td><td>

Description:
Total number of acute care hospitalizations for ambulatory care sensitive conditions in patients younger than age 75
Inclusions:

...

  1. Hospitalization for an ambulatory care sensitive condition is identified as any most responsible diagnosis code of

      ...

        1. Grand mal status and other epileptic convulsions
          ICD-9/9-CM: 345
          ICD-10-CA: G40, G41

      ...

        1. Chronic obstructive pulmonary disease (COPD)

          ...

              1. Any most responsible diagnosis (MRDx) code of
                ICD-9/9-CM: 491, 492, 494, 496
                ICD-10-CA: J41, J42, J43, J44, J47

          ...

              1. MRDx of acute lower respiratory infection, only when a secondary diagnosis* of J44 in
                ICD-10-CA or 496 in ICD-9/9-CM is also present
                ICD-9/9-CM: 466, 480–486, 487.0
                ICD-10-CA: J10.0, J11.0, J12–J16, J18, J20, J21, J22
                *Secondary diagnosis refers to a diagnosis other than the most responsible one.

          ...

            1. Asthma
              ICD-9/9-CM: 493
              ICD-10-CA: J45

          ...

            1. Diabetes
              ICD-9: 250.0, 250.1, 250.2, 250.7
              ICD-9-CM: 250.0, 250.1, 250.2, 250.8
              ICD-10-CA: E10.0, E10.1, E10.63, E10.64, E10.9
              E11.0, E11.1, E11.63, E11.64, E11.9
              E13.0, E13.1, E13.63, E13.64, E13.9
              E14.0, E14.1, E14.63, E14.64, E14.9

          ...

            1. Heart failure and pulmonary edema
              ICD-9/9-CM: 428, 518.4
              ICD-10-CA: I50, J81

          ...

            1. Hypertension
              ICD-9/9-CM: 401.0, 401.9, 402.0, 402.1, 402.9
              ICD-10-CA: I10.0, I10.1, I11

          ...

            1. Angina
              ICD-9: 411, 413
              ICD-9-CM: 411.1, 411.8, 413
              ICD-10-CA: I20, I23.82, I24.0, I24.8, I24.9

          ...

            1. Excluding cases with cardiac procedures.
              List of cardiac procedure codes for exclusion:
              CCP: 47^^, 480^–483^, 489.1, 489.9, 492^–495^, 497^, 498^
              ICD-9-CM: 336, 35^^, 36^^, 373^, 375^, 377^, 378^, 379.4–379.8
              CCI: 1.HA.58.^^, 1.HA.80.^^, 1.HA.87.^^, 1.HB.53.^^, 1.HB.54.^^, 1.HB.55.^^, 1.HB.87.^^, 1.HD.53.^^, 1.HD.54.^^, 1.HD.55.^^, 1.HH.59.^^, 1.HH.71.^^, 1.HJ.76.^^, 1.HJ.82.^^, 1.HM.57.^^, 1.HM.78.^^, 1.HM.80.^^, 1.HN.71.^^, 1.HN.80.^^, 1.HN.87.^^, 1.HP.76.^^, 1.HP.78.^^, 1.HP.80.^^, 1.HP.82.^^, 1.HP.83.^^, 1.HP.87.^^, 1.HR.71.^^, 1.HR.80.^^, 1.HR.84.^^, 1.HR.87.^^, 1.HS.80.^^, 1.HS.90.^^, 1.HT.80.^^, 1.HT.89.^^, 1.HT.90.^^, 1.HU.80.^^, 1.HU.90.^^, 1.HV.80.^^, 1.HV.90.^^, 1.HW.78.^^, 1.HW.79.^^, 1.HX.71.^^, 1.HX.78.^^, 1.HX.79.^^, 1.HX.80.^^, 1.HX.83.^^, 1.HX.86.^^, 1.HX.87.^^, 1.HY.85.^^, 1.HZ.53 rubric (except 1.HZ.53.LA-KP), 1.HZ.54.^^, 1.HZ.55 rubric (except 1.HZ.55.LA-KP), 1.HZ.56.^^, 1.HZ.57.^^, 1.HZ.59.^^, 1.HZ.80.^^, 1.HZ.85.^^, 1.HZ.87.^^, 1.IF.83.^^, 1.IJ.50.^^, 1.IJ.54.GQ-AZ, 1.IJ.55.^^, 1.IJ.57.^^, 1.IJ.76.^^, 1.IJ.80.^^, 1.IJ.86.^^, 1.IK.50.^^, 1.IK.57.^^, 1.IK.80.^^, 1.IK.87.^^, 1.IN.84.^^, 1.LA.84.^^, 1.LC.84.^^, 1.LD.84.^^, 1.YY.54.LA-NJ, 1.YY.54.LA-FS, 1.YY.54.LA-NM, 1.YY.54.LA-FR, 1.YY.54.LA-FU
              Note: Code may be coded in any position. Procedures coded as abandoned after onset (Intervention Status Attribute = A) are excluded.

          ...

          1. Admission to an acute care institution (Facility Type Code = 1)
          2. Age at admission younger than 75

          ...

          1. Sex recorded as male or female

          Exclusions:

          ...

          1. Records with discharge as death (Discharge Disposition Code = 07, 72*, 73*, 74*)

          ...

          1. Newborn, stillbirth or cadaveric donor records (Admission Category Code = N, R or S)


          Note
          *2018–2019 data onward.

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          <div role="button" class="expandableTitle" aria-controls="backgroundRegion">Background, Interpretation and Benchmarks</div>
          
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          Hospitalization for an ambulatory care sensitive condition is considered to be a measure of access to appropriate primary health care. While not all admissions for these conditions are avoidable, it is assumed that appropriate ambulatory care could prevent the onset of this type of illness or condition, control an acute episodic illness or condition, or manage a chronic disease or condition. A disproportionately high rate is presumed to reflect problems in obtaining access to appropriate primary care.

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          Interpretation
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          <tr><td>Interpretation</td><td>
          

          Low rates are desirable.

          Table Row (tr)
          Table Cell (td)
          HSP Framework Dimension
          Table Cell (td) HTML
          
          </td></tr>
          
          <tr><td>HSP Framework Dimension</td><td>
          

          Health System Outputs: Appropriate and effective

          Table Row (tr)
          Table Cell (td)
          Areas of Need
          Table Cell (td) HTML
          
          </td></tr>
          
          <tr><td>Areas of Need</td><td>
          

          Living With Illness, Disability or Reduced Function

          Table Row (tr)
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          Targets/Benchmarks
          td HTML
          
          </td></tr>
          
          <tr><td>Targets/Benchmarks</td><td>
          

          The appropriate level of hospitalization for these conditions is not known, and large regional variations in the rate of hospitalization for these conditions exist.

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          References
          td HTML
          
          </td></tr>
          
          
          <tr><td>References</td><td>
          

          Anderson GM. Common Conditions Considered Sensitive to Ambulatory Care. In Patterns of Health Care in Ontario, 2nd Ed. Eds. V. Goel et al. Ottawa, ON: CMA; 1996: 104-110.

          Billings J, Anderson GM, Newman LS. Recent Findings on Preventable Hospitalizations. Health Aff (Millwood) 1996(15): 239-249.

          Billings J, Zeitel L, Lukomnik J,et al. Impact of Socio-Economic Status on Hospital Use in New York City. Health Aff (Millwood) 1993(12): 162-173.

          Manitoba Centre for Health Policy and Evaluation. Concept: Ambulatory Care Sensitive (ACS) Conditions. http://mchp-appserv.cpe.umanitoba.ca/viewConcept.php?conceptID=1023Image Added. Published September 26, 2007. Accessed December 14, 2010.

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          <div role="button" class="expandableTitle" aria-controls="availabilityRegion">Availability of Data Sources and Results</div>
          
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          idavailabilityRegion
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          Data Sources
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          DAD, Demography division, Statistics Canada, HMDB

          Table Row (tr)
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          Available Data Years
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          <table id="availabilityRegion">
          
          <tr><td>Data Sources</td><td>
          

          DAD, HMDB

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          <tr><td>Available Data Years</td><td>
          

          Type of Year:
          Fiscal
          First Available Year:
          2010
          Last Available Year:

          ...

          2019

          Table Row (tr)
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          Geographic Coverage
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          </td></tr>
          
          <tr><td>Geographic Coverage</td><td>
          

          All provinces/territories

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          Reporting Level/Disaggregation
          td HTML
          
          </td></tr>
          
          
          <tr><td>Reporting Level/Disaggregation</td><td>
          

          National, Province/Territory, Region, Neighbourhood Income Quintile

          HTML
          
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          <div role="button" class="expandableTitle" aria-controls="resultRegion">Result Updates</div>
          
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          <tr><td>Update Frequency</td><td>
          

          Every year

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          Table Cell (td)
          Indicator Results
          Table Cell (td) HTML
          
          </td></tr>
          
          
          
          <tr><td>Indicator Results</td><td>
          

          Web Tool:
          Your Health System: In Depth
          URL:
          Accessing Indicator Results on Your Health System: In Depth

          Table Row (tr)
          Table Cell (td)
          Updates
          Table Cell (td)

          Beginning with the 2006–2007 rate, the definition of the ambulatory care sensitive conditions indicator was refined to better align it as a measure of primary health care. In the revised definition, the diabetes component includes diabetes with short-term complications and diabetes without mention of complication; angina, hypertension and heart failure components exclude records where cardiac procedures were also coded.

          HTML HTML
          
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          <tr><td>Updates</td><td>
          

          Not applicable

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          <div role="button" class="expandableTitle" aria-controls="qualityRegion">Quality Statement</div>
          
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          <tr><td>Caveats and Limitations</td><td>
          

          Not applicable

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          Trending Issues
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          Beginning with the 2006–2007 rate, the definition of the ambulatory care sensitive conditions indicator was refined. Rates based on the new definition were calculated for the previous years to allow for comparisons over time.

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          Comments
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          <tr><td>Trending Issues</td><td>
          

          Not applicable

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          </td></tr>
          
          
          <tr><td>Comments</td><td>
          

          Indicator results are also available in

          ...

          • 2001-2002
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