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

Comorbidity in patients with chronic obstructive pulmonary disease in family practice: a cross sectional study

“…Furthermore, the system also generates categories, known as Expanded Diagnosis Clusters (EDCs), which group patients by reference to clinical criteria. The ACG ® Case – Mix System has been widely used and has proved its validity to study morbidity and comorbidity [15-18]. …”

Obtaining the mean relative weights of the cost of care in Catalonia (Spain): retrospective application of the adjusted clinical groups case‐mix system in primary health care

“…There is literature available on the use and behaviour of ACG; however, the contributions in the calculation of MRW in Europe are limited [18,19,[25][26][27][28][29]. Our study associates the burden of morbidity with the use of health resources and the costs of care, with the aim of calculating the MRW of each category of the ACG classification system in patients belonging to various PHC centres in Catalonia.…”

“…In our study, age and sex explained 21% of the variability in cost, while when we included medical diagnostics, it increased to 43%. Some studies reviewed show ranges from 7 to 15% and 40 to 53%, respectively [13][14][15][16][17][18][19][25][26][27][28][29]31]. These discrepancies could be due to the version of the ACG grouping system used (53, 96 or 106 categories), to the methodology used to calculate the costs (fixed and/or variable) and/or to the method of the regression model.…”

“…This simplicity of use is adjusted to PHC needs, such as the large volume of information in daily treatment, time restraints, the coexistence of professionals (doctors, nurses, social workers, etc.) and the reiteration of patients in time [11,12,19,25,29].…”

Adjusted Clinical Groups (ACGs) explain the utilization of primary care in Spain based on information registered in the medical records: A cross-sectional study

“…It has been shown that the ACGs case-mix system can explain more than 50% of the variance in health services utilization by primary care patients [22][23][24]. From a practical point of view, the usefulness of diagnosis-based casemix systems in our environment is threatened by the absence of health databases for management purposes.…”