Abstract
BackgroundThe objective was to explore the usefulness of the morbidity risk adjustment system Adjusted Clinical Groups® (ACG), in comparison with age and gender, in explaining and estimating patient costs on an individual level in Swedish primary health care. Data were retrieved from two primary health care centres in southeastern Sweden.MethodsA cross-sectional observational study. Data from electronic patient registers from the two centres were retrieved for 2001 and 2002, and patients were grouped into ACGs, expressing the individual combination of diagnoses and thus the comorbidity. Costs per patient were calculated for both years in both centres. Cost data from one centre were used to create ACG weights. These weights were then applied to patients at the other centre. Correlations between individual patient costs, age, gender and ACG weights were studied. Multiple linear regression analyses were performed in order to explain and estimate patient costs.ResultsThe variation in individual patient costs was substantial within age groups as well as within ACG weight groups. About 37.7% of the individual patient costs could be explained by ACG weights, and age and gender added about 0.8%. The individual patient costs in 2001 estimated 22.0% of patient costs in 2002, whereas ACG weights estimated 14.3%.ConclusionACGs was an important factor in explaining and estimating individual patient costs in primary health care. Costs were explained to only a minor extent by age and gender. However, the usefulness of the ACG system appears to be sensitive to the accuracy of classification and coding of diagnoses by physicians.
Highlights
The objective was to explore the usefulness of the morbidity risk adjustment system Adjusted Clinical Groups® (ACG), in comparison with age and gender, in explaining and estimating patient costs on an individual level in Swedish primary health care
The aim of this study is to explore the usefulness of the ACG system, in comparison with age and gender, in explaining and estimating patient costs on an individual level in a Swedish primary health care (PHC) setting
Ödeshög was involved in this study to create ACG weights, and Ryd was used to explore the usefulness of the ACG system
Summary
The objective was to explore the usefulness of the morbidity risk adjustment system Adjusted Clinical Groups® (ACG), in comparison with age and gender, in explaining and estimating patient costs on an individual level in Swedish primary health care. Accurate methods are needed for estimating the burden of morbidity in a population to enable resource allocation corresponding to the health care needs of the population. This is important in relation to the funding of primary health care (PHC) centres, as there is greater variation in terms of need between localities than between regions or counties [1]. BMC Public Health 2006, 6:36 http://www.biomedcentral.com/1471-2458/6/36 sation and health care costs are of great interest in this context, and a number of factors have been identified in empirical investigations [2]. The studies showed that there was substantial variation in hospital admission rates among general practitioners (GPs) due to socio-demographic patient factors associated with deprivation [4,5]
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