Originales
Medida de los pesos relativos del coste de la asistencia como efecto de la aplicación retrospectiva de los adjusted clinical groups en atención primaria
Measurement of relative cost weights as an effect of the retrospective application of adjusted clinical groups in primary care
Antoni Sicras-Mainar
, Josep Serrat-Tarrés
Autor para correspondencia
asicras@bsa.gs
Correspondencia: Antoni Sicras Mainar. Badalona Serveis Assistencials, S.A. Gaietà Soler, 6-8. 08911 Badalona. Barcelona. España.
Correspondencia: Antoni Sicras Mainar. Badalona Serveis Assistencials, S.A. Gaietà Soler, 6-8. 08911 Badalona. Barcelona. España.
Badalona Serveis Assistencials, S.A., Badalona, Barcelona, España
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class="elsevierStyleTextfn">Originales</span>" "titulo" => "Medida de los pesos relativos del coste de la asistencia como efecto de la aplicación retrospectiva de los <span class="elsevierStyleItalic">adjusted clinical groups</span> en atención primaria" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "132" "paginaFinal" => "141" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Antoni Sicras-Mainar, Josep Serrat-Tarrés" "autores" => array:2 [ 0 => array:4 [ "nombre" => "Antoni" "apellidos" => "Sicras-Mainar" "email" => array:1 [ 0 => "asicras@bsa.gs" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor1" ] ] ] 1 => array:2 [ "nombre" => "Josep" "apellidos" => "Serrat-Tarrés" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Badalona Serveis Assistencials, S.A., Badalona, Barcelona, España" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor1" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Antoni Sicras Mainar. Badalona Serveis Assistencials, S.A. Gaietà Soler, 6-8. 08911 Badalona. Barcelona. España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Measurement of relative cost weights as an effect of the retrospective application of adjusted clinical groups in primary care" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-02-14" "fechaAceptado" => "2005-10-25" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec14052" "palabras" => array:4 [ 0 => "Adjusted clinical groups" 1 => "Pesos relativos" 2 => "Utilización de recursos" 3 => "Atención primaria" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec14051" "palabras" => array:4 [ 0 => "Adjusted clinical groups" 1 => "Relative weights" 2 => "Resources utilization" 3 => "Primary care" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">El objeto del estudio es obtener los pesos relativos medios de los costes de la asistencia con la aplicación retrospectiva de los <span class="elsevierStyleItalic">adjusted clinical groups</span> (ACG) en población atendida por equipos de atención primaria en situación de práctica clínica habitual.</p> <span class="elsevierStyleSectionTitle">Métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo de carácter retrospectivo. Fueron incluidos en el estudio todos los pacientes atendidos por 4 equipos de atención primaria durante el año 2003. Las principales mediciones fueron: variables universales (edad y sexo), dependientes (visitas y costes) y de casuística o comorbilidad. El modelo de costes para cada paciente se estableció diferenciando los costes fijos y los variables. Se efectuó un análisis de regresión lineal múltiple para la predicción de los modelos. El coste relativo de cada ACG se obtuvo dividiendo el coste medio de cada categoría entre el coste medio de toda la población de referencia.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">El número total de pacientes estudiados fue de 62.311 (intensidad de uso del 76,7%), con una media de 4,8 ± 3,2 episodios y 7,8 ± 7,5 visitas/paciente/año. La distribución de los costes fue de 24.135.236,41 €, el 28,9% fijos. El coste unitario total por visita/año fue de 49,62<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>24,71 € y el promedio paciente/año de 387,34<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>145,87 € (pesos relativos de referencia). El poder explicativo de la clasificación ACG fue del 50,1% en las visitas y del 54,9% para los costes totales.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los ACG se muestran como un aceptable sistema de clasificación de pacientes en situación de práctica clínica habitual. De confirmarse los resultados posibilitarían una mejora en la aplicación práctica de los ACG como una posible herramienta para la gestión clínica en los centros de atención primaria.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">The objective of the study is to obtain the cost’s relative average weights of the assistance with the retrospective application of the Adjusted Clinical Groups (ACG’s) in four teams of Primary Care with an attended population in the habitual clinical practice situation.</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Descriptive study of retrospective character. It was included in the study all attended patients by four teams of Primary Care during year 2003. The main measures were: universal variables (age and gender), dependents (visits and costs) and casuistic and co morbidity. The model of cost per each patient was established differencing the fix costs and the variable ones. Was effected a multiple lineal regression analysis for the prediction of models. The relative cost of each ACG was obtained dividing the average cost of each category among the average cost of each population of reference.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The total number of the studied patients was 62,311 (intensity of use: 76.7%), with an average 4.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.2 episodes and 7.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>7.5 visits/patient/year. The distribution of costs was 24,135,236.41 €, 28.9% for fix. The total unitary cost per visit/year was 49.62<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>24.71 € and the average of the total cost per patient/year 387.34<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>145.87 € (relative weights of reference). The explicative power of the classification of ACG was 50.1% in visits and 54.9% for total costs.</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">The ACG are an acceptable system of classification of patients in situation of habitual clinic practice. 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Información del artículo
ISSN: 02139111Idioma original: Español
DOI:10.1157/13087324
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