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The knowledge of morbidity in primary care as an aid in the planning and management of the services

Semergen doi:10.1016/j.semerg.2009.12.003. Published in Spanish.

Servicio Canario de la Salud, Santa Cruzde Tenerife, Spain

The analysis of the morbidity and management of its knowledge is an old aspiration in Primary Care. The grouping unit (visit, episode,patient),diagnosis classification system and the advance in information technology are the most important aspects conditioning the development of the classification system(case-mix).We have aimed to verify the feasibility of Adjusted Clinical Groups(ACG)of the Johns Hopkins University as an instrument for the analysis of morbidity and to study how much the information obtained and knowledge of it can be of use to us for the planning and management of services in primary care.

Methods: During a one year period, 43,556 patients assigned to family medicine of five Health Care Zones of the area of Tenerife were observed. Comparisons were established between the Health Care Zones and quotas of patients assigned to the family physicians. The ACG software, version 7.1, was used for the analysis as well as descriptive statistics procedures, rate adjustment and multivariate analysis.

Results: Important differences were found between the Zones and quotas in relationship to disease burden. In relationship to the resource usage for the sets of patients, the ACG explained 0.46 of the visits and 0.26 for the cost of the prescription of pharmacy (adjusted r2, po 0.001). These results are similar to those obtained in other studies.

Conclusions: We consider that this tool (ACG) can be very useful because it facilitates the tasks of management and planning of health services.