Primary Care Policy

Future studies should quantitatively validate ACSC lists using individual patient data. Evidence about referral decision-making and diagnostic uncertainty in ambulatory settings is needed from a primary care perspective. Future ACSC frameworks should be validated for specific populations and health systems instead of assumed transferable across countries. Future frameworks should combine clinical expertise, patient or user perspectives, literature support, real-world data, and primary care pathway evidence. ACSC-related hospitalisation rates should be interpreted cautiously when used for trends, regional variation, primary care performance, or pay-for-performance models.