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Application of the Ambulatory Care Groups in the Primary Care of a European National Health Care System

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Bibliographic Data

ID9103102
AuthorsJuan F Orueta (0000-0002-0172-636X, Osakidetza, corresponding author), Josefina Lopez-De-Munain, Koldo Báez, José María Aiarzagüena, Jon I Aranguren, Eduardo Fonseca-Pedrero (0000-0001-7453-5225), Eduardo Pedrero
Year1999
Volume37
Issue3
Pages238-248
Publication date1999-03-01
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-199903000-00004
PMID10098568
OpenAlexW2008423093
LanguageEN
Citations received10
References cited11

BACKGROUND: Ambulatory Care Groups (ACGs), a US case-mix system that uses the patient as the unit of analysis, is particularly appropriate for health care systems in which physicians serve a defined list of patients. OBJECTIVE: To determine the extent to which the categorization of patients according to ACGs would account for the utilization of primary care services in a national health care system within the European Union. METHODS: Of all subjects continuously assigned to 9 physicians from public primary health care centers in Bizkaia, Basque Country (Spain) over a 12-month period, those visited at least once (n = 9,093) were included. According to the subject's age, sex, and ICD-9-CM diagnoses assigned during a year of patient-provider encounters, patients were classified by means of the ACGs system. RESULTS: Multiple linear regression analyses indicated that age and sex did not explain more than 7.1% of the variance in annual visits made by adults and 25.7% by children to primary care physicians. However, the r2 adjusted to the ACGs model was 50% and 48%, respectively, and even higher, that is 58% and 64% for another component of the system, the Ambulatory Diagnostic Groups (ADGs). CONCLUSIONS: Those results support the inadequacy of using the patient's age and sex alone to estimate physicians' workload in the primary health setting and the need to consider morbidity categories. The ACGs case-mix system is a useful tool for incorporating patients' morbidity in the explanation of the use of primary health care services in a European national health system

Ambulatory · Ambulatory care · Case mix index · Family medicine · Health care · Medical diagnosis · Primary care · Public health · Workload · Chronic Disease Management Strategies · Internal Medicine · Medical Coding and Health Information · Medicine · Nursing · Primary Care and Health Outcomes · Pediatrics

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

    Open Access•Andrzej Zielinski, Tomasz Zieliński et al.•BMC Public Health•2009

  • Validating the Johns Hopkins ACG Case-Mix System of the elderly in Swedish primary health care

    Open Access•Anders Halling, Gerd Fridh et al.•BMC Public Health•2006

  • Assessing socioeconomic health care utilization inequity in Israel

    Open Access•Efrat Shadmi, Ran D Balicer et al.•BMC Public Health•2011

  • The importance of comorbidity in analysing patient costs in Swedish primary care

    Open Access•Sven Engström, Sven G Engström et al.•BMC Public Health•2006

  • Licit prescription drug use in a Swedish population according to age, gender and socioeconomic status after adjusting for level of multi-morbidity

    Open Access•Kristine Thorell, Jessica Skoog et al.•BMC Public Health•2012

  • Clinical categories of patients and encounter rates in primary health care – a three-year study in defined populations

    Open Access•Lennart Carlsson, Lars‐Erik Strender et al.•BMC Public Health•2006

  • Can gender difference in prescription drug use be explained by gender-related morbidity

    Open Access•Jessica Skoog, Patrik Midlöv et al.•BMC Public Health•2014

  • A Review on Methods of Risk Adjustment and their Use in Integrated Healthcare Systems

    Open Access•Christin Juhnke, Susanne Bethge et al.•International Journal of…•2016

  • Assessing Comorbidity Using Claims Data

    Carrie N Klabunde, Roger Vernières et al.•Medical Care•2002

  • Performance of the ACG Case-Mix System in Two Canadian Provinces

    Robert J Reid, Leonard Macwilliam et al.•Medical Care•2001

  • Systemwide Provider Performance in a Medicaid Program

    Neil R Powe, Jonathan P Weiner et al.•Medical Care•1996

  • Development and Application of a Population-Oriented Measure of Ambulatory Care Case-Mix

    Jonathan P Weiner, Barbara Starfield et al.•Medical Care•1991

  • Patient-Mix Differences Among Ambulatory Providers and Their Effects on Utilization and Payments for Maryland Medicaid Users

    Mary Stuart, Mary E Stuart et al.•Medical Care•1993

Citations per year0.4
Citation span2001 - 2016 (16)
Highly citedNo
Open DOI
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