Skip Navigation

The European Journal of Public Health 1999 9(1):27-35; doi:10.1093/eurpub/9.1.27
© 1999 by European Journal of Public Health
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (7)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by JUNCOSA, S.
Right arrow Articles by TOMAS, R.
Right arrow Search for Related Content
PubMed
Right arrow Articles by JUNCOSA, S.
Right arrow Articles by TOMAS, R.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

CASEMIX

Performance of an ambulatory casemix measurement system in primary care in Spain: Ambulatory care groups (ACGs)

SEBASTIAN JUNCOSA1,, BONAVENTURA BOLIBAR2, MONTSERRAT ROSET1 and ROSA TOMAS3

1Unitat d'Investigació Centre, Subdivisió d'Atenció Primaria Centre i Lleida, Institut Català de la Salut Terrassa (Barcelona), Spain
2Unitat d'Investigació Centre, Regió Sanitaria Centre, Servei Català de la Salut, Spain
3IASIST, HCIA International Group Spain

Correspondence: Sebastián Juncosa, MD, PHD, Unitat d'Investigació Centre, Subdivisió d'Atenció Primària Centre i Lleida, Institut Català de la Salut, c/ Torrebonica s/n, 08027 Terrassa (Barcelona), Spain, tel. +34 93 7862412, fax +34 93 7839777, e-mail: sjuncosa{at}sapcll.scs.es

Background: Patient classification systems based on the defining of iso-resources provide useful tools for the analysis, management and financing of health care services. However, their development and application in an ambulatory setting are still in their first steps. Furthermore, these systems, which are often created in the USA, have to be adapted to the characteristics of primary care (PC) in Europe. Because we think that ambulatory care groups (ACGs) can be used in PC, we evaluated their performance in a region of Spain. Methods: We used the data from a study based on 13 voluntary doctor and nurse teams which followed a random sample of 2,467 patients for a mean of six months. We used sex, patient age and ICD-9-CM diagnoses of the episodes of care of the patients to assign an ACG to each patient. We used the number of visits, number of episodes, PC cost and total cost per patient as dependent variables to evaluate the ACG performance. Results: In the ACG distribution obtained, the ten most frequent ACGs accounted for 66% of patients and only two ACG classes were empty. Most ACGs showed a consistent relative weight throughout the different measures of resource use and much lower coefficients of variation for the four dependent variables than the total population. However, ACG 4, 5 and 16 showed a high heterogeneity between the four dependent variables. The ACGs showed an explanatory power of 64% for the number of episodes per patient, 44% for visits per patient, 41% for PC costs and 31% for total costs. Conclusions: ACGs came closest to meeting some theoretical needs of the European PC system with a covered population. The performance of the ACGs groups is acceptable and the results obtained are not very different from those obtained by the authors.

Keywords: ambulatory care, ambulatory care groups, casemix, primary care


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Eur J Public HealthHome page
A. Sicras-Mainar, J. Serrat-Tarres, R. Navarro-Artieda, R. Llausi-Selles, I. Ruano-Ruano, and J. A. Gonzalez-Ares
Adjusted Clinical Groups use as a measure of the referrals efficiency from primary care to specialized in Spain
Eur J Public Health, December 1, 2007; 17(6): 657 - 663.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.