Impact of Integrated Care on the Rate of Hospitalization for Ambulatory Care Sensitive Conditions among Older Adults in Stockholm County: An Interrupted Time Series Analysis

Introduction: Reducing avoidable hospital admissions is often viewed as a possible positive consequence of introducing integrated care (IC). The aim of this study was to investigate the impact of implementing IC in Norrtalje on the rate of admissions for ambulatory care sensitive conditions (ACSC). Method: Using interrupted time series analyses we investigated the effect of implementing IC in Norrtalje municipality in the northern part of Stockholm county, Sweden. The time period included 48 time points, from year 2000 to year 2011 with measurements before and after introducing IC in Norrtalje in 2006. In order to control for other extraneous events that could affect the outcome measure, but not related to the introduction of IC, we included a control population from Stockholm municipality. Results: After introducing IC in Norrtalje the rate of admissions for ACSC decreased. This decrease was greater in Norrtalje than in the matched control population, however the difference between the two areas was not statistically significant (p = 0.08). Conclusion: Introducing IC in Norrtalje may have had positive impact on admissions for ACSC for older people living in Norrtalje; however, the interpretation of the impact of IC on admissions for ACSC is complicated by intervening policy changes in health and social care during the study period.