Available online 7 October 2022

We systematically reviewed interventions including/consisting of community health services and social care.

Outcome of interest was the hospitalization rate for ambulatory care sensitive conditions.

The structural feature shared by all successful interventions was physician involvement.

The behavioral feature shared by all successful interventions was care management.

Preventing hospitalizations due to ambulatory care sensitive conditions (ACSCs) is traditionally the responsibility of primary care. The determinants of ACSC hospitalizations, however, are not purely medical, but also influenced by other factors like patients’ social and personal circumstances. Interventions that include or consist entirely of community health services and social care could potentially reduce the ACSC hospitalization rate. Comparisons of the features of successful interventions of this nature, however, are still lacking. We therefore conducted a systematic review of the literature to identify out-of-hospital interventions that (a) included aspects or consisted entirely of community health services and social care and (b) analyzed the ACSC hospitalization rate as an outcome measure.

We identified papers reporting the results of 32 interventions and extracted structural and behavioral features to determine which of these were shared by most or all of the successful interventions.

We found that all of the successful interventions included a primary care physician and provided care management. Moreover, most of the successful interventions were characterized by a high degree of interconnectedness between professional groups and provided care within so-called health care homes. We also identified a set of care coordination activities that were implemented in most of the successful interventions. Policy makers may wish to consider adopting these features when designing interventions that aim to reduce the ACSC hospitalization rate.

ambulatory care sensitive condition

community health services

social care

systematic literature review

intervention features

© 2022 The Author(s). Published by Elsevier B.V.