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M any chronic conditions, such as diabetes or asthma, can be successfully managed in the community. Appropriate screening, ongoing monitoring, prescribing of medications, providing patient education and other supportive measures that help keep these conditions under control are provided in primary healthcare settings. However, sometimes people with such conditions require hospitalization. Although not all admissions for these conditions are avoidable, timely and effective ambulatory care can potentially reduce the risk of hospitalization by possibly preventing or controlling the onset of an illness or condition or by managing the chronic condition (World Health Organization 2005). These conditions are often referred to as ambulatory care sensitive conditions (ACSC). The conditions used to define ACSC in this analysis include angina, asthma, chronic obstructive pulmonary disorder (COPD), diabetes, grand mal status and other epileptic convulsions, heart failure and pulmonary edema and hypertension (Canadian Institute for Health Information 2008). This is based on an adaptation of the widely used definition of ACSC by Billings et al. (1993). Research shows that variations in ACSC hospitalization rates may be related to factors such as differences in access to and quality of primary healthcare (Ansari et al. 2006; Caminal et al. 2004). They may also be due to differences in communityor hospital-based practice patterns or other factors.

CIHI Survey: Variations in Canadian Rates of Hospitalization for Ambulatory Care Sensitive Conditions