Primary Care Physicians’ Ratings of Ambulatory Care–Sensitive Hospitalizations (N=104)
| Attributed Causesa | Potentially Avoidable No. (%) | Not Avoidable No. (%) |
|---|---|---|
| Total | 43 (41) | 61 (59) |
| System level | 19 (63) | 11 (37) |
| Absence of treating physician | 7 (70) | 3 (30) |
| Unavailability of ambulatory services | 5 (50) | 5 (50) |
| Failure to utilize ambulatory services | 7 (88) | 3 (12) |
| Physician level | 12 (38) | 20 (62) |
| Diagnostic uncertainty | 2 (25) | 6 (75) |
| Ambulatory treatment failure | 4 (24) | 13 (76) |
| Suboptimal monitoring | 6 (86) | 1 (14) |
| Medical | 19 (19) | 82 (81) |
| Medication side effects | 1 (17) | 5 (83) |
| Medical emergency | 0 (0) | 33 (100) |
| Somatic comorbidity | 9 (24) | 29 (76) |
| Psychiatric comorbidity | 3 (33) | 6 (67) |
| Substance abuse | 2 (33) | 4 (67) |
| Fall | 4 (44) | 5 (56) |
| Patient level | 45 (54) | 38 (46) |
| Fearfulness | 7 (64) | 4 (37) |
| Cultural background | 5 (56) | 4 (45) |
| Insufficient language skills | 6 (67) | 3 (33) |
| Delayed help seeking | 5 (71) | 2 (29) |
| Medication error | 4 (100) | 0 |
| Medication nonadherence | 11 (52) | 10 (48) |
| Nonmedication nonadherence | 6 (38) | 10 (63) |
| Cognitive impairment | 1 (17) | 5 (83) |
| Social level | 9 (45) | 11(55) |
| Lack of social support | 5 (46) | 6 (55) |
| Overprotective caregiver | 3 (75) | 1 (25) |
| Overstrained caregiver | 1 (20) | 4 (80) |
↵a Multiple causes could be attributed to each ambulatory care–sensitive hospitalization.