papers

Types of morbidity and categories of patients in a Swedish county. Applying the Johns Hopkins Adjusted Clinical Groups System to encounter data in primary health care

Scand J Prim Health Care 22:174-179.

Center for Family Medicine, Department of Clinical Science, Karolinska Institute, Stockholm, Sweden

OBJECTIVE: To elucidate types of morbidity and categories of patients in a large population.

DESIGN: A one-year retrospective study of encounter data from electronic patient record databases in primary health care, with application of the Johns Hopkins Adjusted Clinical Groups System.

SETTING: Blekinge County Council, southeastern Sweden, with 149 552 inhabitants.

SUBJECTS: All patients with a diagnosis-registered encounter with a GP in 2002 at 13 publicly managed PHC centres.

MAIN OUTCOME MEASURES: Anonymous identification number, age, gender, type of morbidity (Aggregated Diagnostic Groups), and category of patient (Adjusted Clinical Groups).

RESULTS: About 45% of the county’s inhabitants had at least one diagnosis-registered encounter with a GP during the year. The most common types of morbidity were “time limited” (24.0% of all types), “likely to recur” (19.6%), and “signs/symptoms” (19.0%). About 33.3% of all patients had one and only one time-limited condition, about 16.8% had one and only one recurring condition, and about 12.1% of the patients had only a chronic condition.

CONCLUSION: Types of morbidity in primary health care are dominated by nearly equal proportions of “time limited”, “likely to recur”, “chronic”, and “signs/symptoms”. The predominant categories of patients are those with only one type of morbidity, while about one-third of the patients had a constellation of two or more types of morbidity during a one-year period.

PMID: 15370795