{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T14:49:21Z","timestamp":1792507761745,"version":"4.5.0"},"reference-count":42,"publisher":"Public Library of Science (PLoS)","issue":"1","license":[{"start":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T00:00:00Z","timestamp":1609977600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014467","name":"Western Sydney Local Health District","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014467","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Mid North Coast LHD"},{"name":"North Coast Primary Health Network"},{"name":"NSW Agency for Clinical Innovation"},{"name":"University Centre for Rural Health"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nIntroduction<\/jats:title>\nReducing potentially preventable hospitalisations (PPH) is a priority for health services. This paper describes the factors that clinicians perceived contributed to preventable admissions for angina, diabetes, congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD), and what they considered might have been done in the three months leading up to an admission to prevent it.<\/jats:p>\n<\/jats:sec>\n\nMethods<\/jats:title>\nThe study was conducted in a rural and a metropolitan health district in NSW, Australia. Expert Panels reviewed detailed case reports to assess preventability. For those admissions identified as preventable, comments from clinicians indicating what they perceived could have made a difference and\/or been done differently to prevent each of the preventable admissions were analysed qualitatively.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\n148 (46%) of 323 admissions were assessed as preventable. Across the two districts, the most commonly identified groups of contributing factors to preventable admissions were: \u2018Systems issues: Community based services missing or inadequate or not referred to\u2019; \u2018Patient issues: Problems with adherence\/self-management\u2019; and \u2018Clinician issues: GP care inadequate\u2019. In some instances, important differences drove these groups of factors. For example, in the rural district \u2018Systems issues: Community based services missing or inadequate or not referred to\u2019 was largely driven by social and welfare support services missing\/inadequate\/not referred to, whereas in the metropolitan district it was largely driven by community nursing, allied health, care coordination or integrated care services missing\/inadequate\/not referred to. Analyses revealed the complexity of system, clinician and patient factors contributing to each admission. Admissions for COPD (rural) and CHF (metropolitan) admissions showed greatest complexity.<\/jats:p>\n<\/jats:sec>\n\nDiscussion and conclusion<\/jats:title>\nThese findings suggest preventability of individual admissions is complex and context specific. There is no single, simple solution likely to reduce PPH. Rather, an approach addressing multiple factors is required. This need for comprehensiveness may explain why many programs seeking to reduce PPH have been unsuccessful.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0244313","type":"journal-article","created":{"date-parts":[[2021,1,7]],"date-time":"2021-01-07T22:50:10Z","timestamp":1610059810000},"page":"e0244313","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":6,"title":["What could prevent chronic condition admissions assessed as preventable in rural and metropolitan contexts? An analysis of clinicians\u2019 perspectives from the DaPPHne study"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8257-7772","authenticated-orcid":true,"given":"Jo","family":"Longman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Johnston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Ewald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Gilliland","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Burke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tabeth","family":"Mutonga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Passey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,1,7]]},"reference":[{"key":"pone.0244313.ref001","unstructured":"Council of Australian Governments. 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