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Adaptation of the categories Johns-Hopkins ACG Case-Mix System in primary healthcare: a longitudinal, retrospective claim database study

Published: March 1, 2011
Category: Reports
Authors: Aguado-Jodar A, Bolibar Ribas B, Hermosilla-Perez E, Navarro-Artieda R, Plana-Ripoll O, Prados-Torres A, Ruiz-Torrejon A, Sicras-Mainar A, Velasco-Velasco S, Violan-Fors C
Country: Spain
Language: null
Type: Care Management
Setting: Hospital

WebmedCentral ECONOMICS OF MEDICINE 2:WMC001657.

Directorate of Planning, Badalona Serveis Assistencials SA, Badalona, Spain

BACKGROUND: To determine the adaptation capacitating of categories case-mix adjustment (Adjusted Clinical Groups [ACG]) in Primary healthcare (PHC) in function of the cost of care in routine clinical practice.

METHODS/DESIGN: Retrospective study based on computerized medical records. All patients attended by 14 PHC teams in 2009 are included. The principle measurements were: demographic variables (age and sex), dependent variables (costs of care) and case-mix or morbidity (Johns Hopkins University Adjusted Clinical Groups Case-Mix System) variables. Episodes occurring in the study population will be accounted for by the date of registration in the clinical history for each episode/reason for consultation, whether acute or chronic, regardless of the date of initiation of the diagnostic process. ICPC-2 will be converted (mapped) to ICD-9-MC. The costs model for each patient will be established by differentiating the fix costs from the variable costs. Fix-costs: staff (wages and salaries), consumer goods, external services (structure and management); and variable-costs (laboratory, conventional-radiology, diagnostic tests, referrals and prescriptions). In the analysis, the ANOVA, chi-squared, Pearson’s lineal correlation and Mann-Whitney-Wilcoxon tests will be used. The adaptation capacitating of each category was obtained: a) outliers (atypical observations), and b) variation of Pearson coefficient. Predictive model of cost: coefficient of determination (R2) will be measured, p

DISCUSSION: The proliferation of similar studies, with homogenous definition criteria between variables, would favor the possibility of benchmarking between centres and professionals from different organizations.

Predictive Risk Modeling,Cost Burden Evaluation,Morbidity Patterns,Spain,Resource Use, Primary Care, Case-Mix, Health Care Costs, Retrospective Study, Morbidity, Management

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