Validation of ACG Case-mix for equitable resource allocation in Swedish primary health care

Andrzej Zielinski, Maria Kronogård, Håkan Lenhoff, Anders Halling

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Udgivelsesdato: 2009-null
OriginalsprogEngelsk
TidsskriftBMC Public Health
Vol/bind9
Sider (fra-til)347
ISSN1471-2458
DOI
StatusUdgivet - 1. jan. 2009
Udgivet eksterntJa

Fingeraftryk

Primary Health Care
Linear Models
Health Resources
Age Factors
Public Health
Delivery of Health Care

Citer dette

Zielinski, Andrzej ; Kronogård, Maria ; Lenhoff, Håkan ; Halling, Anders. / Validation of ACG Case-mix for equitable resource allocation in Swedish primary health care. I: BMC Public Health. 2009 ; Bind 9. s. 347.
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title = "Validation of ACG Case-mix for equitable resource allocation in Swedish primary health care",
abstract = "BACKGROUND: Adequate resource allocation is an important factor to ensure equity in health care. Previous reimbursement models have been based on age, gender and socioeconomic factors. An explanatory model based on individual need of primary health care (PHC) has not yet been used in Sweden to allocate resources. The aim of this study was to examine to what extent the ACG case-mix system could explain concurrent costs in Swedish PHC. METHODS: Diagnoses were obtained from electronic PHC records of inhabitants in Blekinge County (approx. 150,000) listed with public PHC (approx. 120,000) for three consecutive years, 2004-2006. The inhabitants were then classified into six different resource utilization bands (RUB) using the ACG case-mix system. The mean costs for primary health care were calculated for each RUB and year. Using linear regression models and log-cost as dependent variable the adjusted R2 was calculated in the unadjusted model (gender) and in consecutive models where age, listing with specific PHC and RUB were added. In an additional model the ACG groups were added. RESULTS: Gender, age and listing with specific PHC explained 14.48-14.88{\%} of the variance in individual costs for PHC. By also adding information on level of co-morbidity, as measured by the ACG case-mix system, to specific PHC the adjusted R2 increased to 60.89-63.41{\%}. CONCLUSION: The ACG case-mix system explains patient costs in primary care to a high degree. Age and gender are important explanatory factors, but most of the variance in concurrent patient costs was explained by the ACG case-mix system.",
author = "Andrzej Zielinski and Maria Kronog{\aa}rd and H{\aa}kan Lenhoff and Anders Halling",
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Validation of ACG Case-mix for equitable resource allocation in Swedish primary health care. / Zielinski, Andrzej; Kronogård, Maria; Lenhoff, Håkan; Halling, Anders.

I: BMC Public Health, Bind 9, 01.01.2009, s. 347.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Validation of ACG Case-mix for equitable resource allocation in Swedish primary health care

AU - Zielinski, Andrzej

AU - Kronogård, Maria

AU - Lenhoff, Håkan

AU - Halling, Anders

PY - 2009/1/1

Y1 - 2009/1/1

N2 - BACKGROUND: Adequate resource allocation is an important factor to ensure equity in health care. Previous reimbursement models have been based on age, gender and socioeconomic factors. An explanatory model based on individual need of primary health care (PHC) has not yet been used in Sweden to allocate resources. The aim of this study was to examine to what extent the ACG case-mix system could explain concurrent costs in Swedish PHC. METHODS: Diagnoses were obtained from electronic PHC records of inhabitants in Blekinge County (approx. 150,000) listed with public PHC (approx. 120,000) for three consecutive years, 2004-2006. The inhabitants were then classified into six different resource utilization bands (RUB) using the ACG case-mix system. The mean costs for primary health care were calculated for each RUB and year. Using linear regression models and log-cost as dependent variable the adjusted R2 was calculated in the unadjusted model (gender) and in consecutive models where age, listing with specific PHC and RUB were added. In an additional model the ACG groups were added. RESULTS: Gender, age and listing with specific PHC explained 14.48-14.88% of the variance in individual costs for PHC. By also adding information on level of co-morbidity, as measured by the ACG case-mix system, to specific PHC the adjusted R2 increased to 60.89-63.41%. CONCLUSION: The ACG case-mix system explains patient costs in primary care to a high degree. Age and gender are important explanatory factors, but most of the variance in concurrent patient costs was explained by the ACG case-mix system.

AB - BACKGROUND: Adequate resource allocation is an important factor to ensure equity in health care. Previous reimbursement models have been based on age, gender and socioeconomic factors. An explanatory model based on individual need of primary health care (PHC) has not yet been used in Sweden to allocate resources. The aim of this study was to examine to what extent the ACG case-mix system could explain concurrent costs in Swedish PHC. METHODS: Diagnoses were obtained from electronic PHC records of inhabitants in Blekinge County (approx. 150,000) listed with public PHC (approx. 120,000) for three consecutive years, 2004-2006. The inhabitants were then classified into six different resource utilization bands (RUB) using the ACG case-mix system. The mean costs for primary health care were calculated for each RUB and year. Using linear regression models and log-cost as dependent variable the adjusted R2 was calculated in the unadjusted model (gender) and in consecutive models where age, listing with specific PHC and RUB were added. In an additional model the ACG groups were added. RESULTS: Gender, age and listing with specific PHC explained 14.48-14.88% of the variance in individual costs for PHC. By also adding information on level of co-morbidity, as measured by the ACG case-mix system, to specific PHC the adjusted R2 increased to 60.89-63.41%. CONCLUSION: The ACG case-mix system explains patient costs in primary care to a high degree. Age and gender are important explanatory factors, but most of the variance in concurrent patient costs was explained by the ACG case-mix system.

U2 - 10.1186/1471-2458-9-347

DO - 10.1186/1471-2458-9-347

M3 - Journal article

VL - 9

SP - 347

JO - B M C Public Health

JF - B M C Public Health

SN - 1471-2458

ER -