Utilización de los grupos clínicos ajustados en un centro de atención primaria español: estudio retrospectivo de base poblacional

Sicras‐Mainar, Antoni; Pané-Mena, Olga; Martínez-Ruíz, Teresa; Fernández-Roure, Josep Lluís; Prats-Sánchez, Jordi; Santafé, Lourdes; Navarro‐Artieda, Ruth; Prados‐Torres, Alexandra; Estelrich-Bennasar, Jose

doi:10.1590/s1020-49892010000100008

Cited by 3 publications

(11 citation statements)

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“…Specifically, the ACG case-mix system was validated in Spain by a 2005 retrospective, multi-centre study of 81,873 patients [30] and in a Swedish community-based study [31]. The ACG index ( RI ) used as an indicator of morbidity burden was selected for two reasons: First, it is well established, internationally validated, and well documented for use in risk calculation [11,14]. Second, although many indicators of morbidity burden are available (e.g., Aggregated Diagnosis Groups [ADG], Major ADG, ACG-related relative weight), the RI would also establish the disease burden for each BCT.…”

Section: Discussionmentioning

confidence: 99%

“…Defined by the ratio between average expected visits in a PHC or BCT and average number of visits of the reference population [11], an RI value equal to one signified a health complexity equal to the 2008 standard, whereas an RI >1 represented greater complexity and <1 weaker complexity. The RI reflected the complexity of cases attended by a PHC or BCT with respect to the reference population standard.…”

Section: Methodsmentioning

confidence: 99%

“…In addition, predictive models of utilization have been designed that can identify population groups with the potential for very high levels of resource consumption [10,11], classify the types of patients attended, and expedite costs forecasting.…”

Section: Introductionmentioning

confidence: 99%

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Relationship between efficiency and clinical effectiveness indicators in an adjusted model of resource consumption: a cross-sectional study

Violán

Plana‐Ripoll

Foguet-Boreu

et al. 2013

BMC Health Serv Res

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BackgroundAdjusted clinical groups (ACG®) have been widely used to adjust resource distribution; however, the relationship with effectiveness has been questioned. The purpose of the study was to measure the relationship between efficiency assessed by ACG® and a clinical effectiveness indicator in adults attended in Primary Health Care Centres (PHCs).MethodsResearch design: cross-sectional study. Subjects: 196, 593 patients aged >14 years in 13 PHCs in Catalonia (Spain). Measures: Age, sex, PHC, basic care team (BCT), visits, episodes (diagnoses), and total direct costs of PHC care and co-morbidity as measured by ACG® indicators: Efficiency indices for costs, visits, and episodes (costs EI, visits EI, episodes EI); a complexity or risk index (RI); and effectiveness measured by a general synthetic index (SI). The relationship between EI, RI, and SI in each PHC and BCT was measured by multiple correlation coefficients (r).ResultsIn total, 56 of the 106 defined ACG® were present in the study population, with five corresponding to 44.5% of the patients, 11 to 68.0% of patients, and 30 present in less than 0.5% of the sample. The RI in each PHC ranged from 0.9 to 1.1. Costs, visits, and episodes had similar trends for efficiency in six PHCs. There was moderate correlation between costs EI and visits EI (r = 0.59). SI correlation with episodes EI and costs EI was moderate (r = 0.48 and r = −0.34, respectively) and was r = −0.14 for visits EI. Correlation between RI and SI was r = 0.29.ConclusionsThe Efficiency and Effectiveness ACG® indicators permit a comparison of primary care processes between PHCs. Acceptable correlation exists between effectiveness and indicators of efficiency in episodes and costs.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Relationship between efficiency and clinical effectiveness indicators in an adjusted model of resource consumption: a cross-sectional study

Violán

Plana‐Ripoll

Foguet-Boreu

et al. 2013

BMC Health Serv Res

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“… 3 realizados en Argentina (López, Findling & Abramzón, 2006;Jorrat, Fernández & Marconi, 2008;Pantelides & Gaudio, 2009), 3 en Brasil (Dias-da-Costa et al, 2008;Louvison et al, 2008;Bastos Gisele et al, 2011;Pilger et al, 2013),  3 en España (Sáez, 2003;Muñoz-de Bustillo & Antón, 2010;Sicras-Mainar et al, 2010),  2 en Cuba (Díaz Piñera et al, 2012;García Roche, Rodríguez Salvá & de Vos Pol, 2012),…”

Section: Estado Del Arteunclassified

“…Encontramos que la gran mayoría definía a la utilización de servicios como uso, consulta, visita, atención o contacto con un profesional de la salud (Sáez, 2003;Dias-da-Costa et al, 2008;Jorrat, Fernández & Marconi, 2008;Louvison et al, 2008;Llanos et al, 2009;Morera & Aparicio, 2010;Muñoz-de Bustillo & Antón, 2010;Sicras-Mainar et al, 2010;Bastos Gisele et al, 2011;Díaz Piñera et al, 2012;García Roche, Rodríguez Salvá & de Vos Pol, 2012;López-Cevallos & Chunhuei, 2012;Pérez-Cuevas et al, 2012;Petrera et al, 2013;Pilger et al, 2013;Vásquez, Paraje & Estay, 2013).…”

Section: Estado Del Arteunclassified

Análisis de la utilización de los servicios del Centro de Salud y Acción Social Comunitaria Nº 35 focalizado en los varones entre 2005 y 2011 (Ciudad Autónoma de Buenos Aires)

Calvetti¹

2014

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Men between 18 and 65 years old use health services less frequently for preventive care than women, this situation is influenced by social and biological components. Promoting health and preventing disease could contribute to diminish morbidity and mortality in this population. Health campaigns and provision of services in primary care are mainly directed to the mother-child population, this produces an inequity situation for men. The objective of this research is to analyze the difference in the utilization of the services provided by "centro de salud 35" between men and women. Methodology: observational epidemiological study, descriptive, cross-sectional between the years 2005 and 2011. We found that for every man who consults for preventive practices 2 women consult and men consult les frequently than women. 70% of the men and 50% of the women analyzed lost the opportunity for a preventive practice related to the periodic health examination. The social construction of masculinity and health policies negatively influence the utilization of health services by men.

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Primary care emergency services utilization in German-speaking Switzerland: A population-based cross-sectional study

Güntensperger¹,

Pinzello-Hürlimann²,

Martina³

et al. 2010

Swiss Med Wkly

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Nearly 1 out of 1000 inhabitants were looking for emergency primary care help, and 10% of the patients were seen urgently by general practitioners and hospital staff and were hospitalised. These numbers are important information for planning emergency primary care facilities. The most prevalent triage diagnoses in practice are infections, traumatological reasons and ENT-problems, whereas in hospital the most frequent triage diagnosis is a traumatological disorder, followed by thoracic pain and infections. In addition, GP's treat patients more rapidly than a hospital does and treat patients in shorter time intervals.

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Utilización de los grupos clínicos ajustados en un centro de atención primaria español: estudio retrospectivo de base poblacional

Abstract: The ACG system allowed this patient population to be grouped by clinical status, which can help to, among other things, allocate resources and evaluate PHC team efficiency.

Cited by 3 publications

References 19 publications

Relationship between efficiency and clinical effectiveness indicators in an adjusted model of resource consumption: a cross-sectional study

Relationship between efficiency and clinical effectiveness indicators in an adjusted model of resource consumption: a cross-sectional study

Análisis de la utilización de los servicios del Centro de Salud y Acción Social Comunitaria Nº 35 focalizado en los varones entre 2005 y 2011 (Ciudad Autónoma de Buenos Aires)

Primary care emergency services utilization in German-speaking Switzerland: A population-based cross-sectional study

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