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

Zielinski, Andrzej LU ; Kronogard, Maria; Lenhoff, Hakan and Halling, Anders LU (2009) In BMC Public Health 9.
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... (More)
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 R-2 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 R-2 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. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMC Public Health
volume
9
publisher
BioMed Central
external identifiers
  • wos:000270676200003
  • scopus:70350365824
ISSN
1471-2458
DOI
10.1186/1471-2458-9-347
language
English
LU publication?
yes
id
5f40fffb-bb71-4f4a-a0bb-c4a40a955dea (old id 1507594)
date added to LUP
2009-11-20 12:10:22
date last changed
2017-07-02 04:11:19
@article{5f40fffb-bb71-4f4a-a0bb-c4a40a955dea,
  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 R-2 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 R-2 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       = {Zielinski, Andrzej and Kronogard, Maria and Lenhoff, Hakan and Halling, Anders},
  issn         = {1471-2458},
  language     = {eng},
  publisher    = {BioMed Central},
  series       = {BMC Public Health},
  title        = {Validation of ACG Case-mix for equitable resource allocation in Swedish primary health care},
  url          = {http://dx.doi.org/10.1186/1471-2458-9-347},
  volume       = {9},
  year         = {2009},
}