Revista Panamericana de Salud Pública
Print version ISSN 1020-4989
SICRAS-MAINAR, Antoni et al. Adjusted clinical groups use at a Spanish primary care center: a retrospective, population-based study. Rev Panam Salud Publica [online]. 2010, vol.27, n.1, pp. 49-55. ISSN 1020-4989. http://dx.doi.org/10.1590/S1020-49892010000100008.
OBJECTIVES: To evaluate the results of implementing a classification system based on adjusted clinical groups (ACG) at a primary health care (PHC) in a Spanish population. METHODS: A retrospective, cross-sectional study based on the computerized medical records of outpatients seen in 2007 by the La Roca clinic, administered by a health services management company in La Roca del Vallès, Barcelona, Spain. The ACGs were formed according to the International Classification of Diseases, 9th Revision, Clinical Modification. The relative weight of each ACG's total average cost was calculated (in U.S. dollars) and based on these, the resources usage levels were established. The risk index (RI) and efficiency index (EI) for 2006 and the classification's explanatory power were determined. RESULTS: A total of 8 294 patients were studied (82.7% coverage), with an average of 4.1 incidents per patient, 6.9 visits per patient, and 5.7 visits per person per year. Seven GCAs accounted for 51.0% of patients seen. The RI was 1.015, the EI was 0.975 visits, and the explanatory power of the ACG classification was 53.4% for visits and 74.8% for incidents. CONCLUSIONS: 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.
Keywords : Diagnosis-related groups; primary health care; efficiency; organizational; Spain.