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        "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 aplicaci&#243;n retrospectiva de los <span class="elsevierStyleItalic">adjusted clinical groups</span> &#40;ACG&#41; en poblaci&#243;n atendida por equipos de atenci&#243;n primaria en situaci&#243;n de pr&#225;ctica cl&#237;nica habitual&#46;</p> <span class="elsevierStyleSectionTitle">M&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Estudio descriptivo de car&#225;cter retrospectivo&#46; Fueron incluidos en el estudio todos los pacientes atendidos por 4 equipos de atenci&#243;n primaria durante el a&#241;o 2003&#46; Las principales mediciones fueron&#58; variables universales &#40;edad y sexo&#41;&#44; dependientes &#40;visitas y costes&#41; y de casu&#237;stica o comorbilidad&#46; El modelo de costes para cada paciente se estableci&#243; diferenciando los costes fijos y los variables&#46; Se efectu&#243; un an&#225;lisis de regresi&#243;n lineal m&#250;ltiple para la predicci&#243;n de los modelos&#46; El coste relativo de cada ACG se obtuvo dividiendo el coste medio de cada categor&#237;a entre el coste medio de toda la poblaci&#243;n de referencia&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">El n&#250;mero total de pacientes estudiados fue de 62&#46;311 &#40;intensidad de uso del 76&#44;7&#37;&#41;&#44; con una media de 4&#44;8 &#177; 3&#44;2 episodios y 7&#44;8 &#177; 7&#44;5 visitas&#47;paciente&#47;a&#241;o&#46; La distribuci&#243;n de los costes fue de 24&#46;135&#46;236&#44;41 &#8364;&#44; el 28&#44;9&#37; fijos&#46; El coste unitario total por visita&#47;a&#241;o fue de 49&#44;62<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>24&#44;71 &#8364; y el promedio paciente&#47;a&#241;o de 387&#44;34<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>145&#44;87 &#8364; &#40;pesos relativos de referencia&#41;&#46; El poder explicativo de la clasificaci&#243;n ACG fue del 50&#44;1&#37; en las visitas y del 54&#44;9&#37; para los costes totales&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Los ACG se muestran como un aceptable sistema de clasificaci&#243;n de pacientes en situaci&#243;n de pr&#225;ctica cl&#237;nica habitual&#46; De confirmarse los resultados posibilitar&#237;an una mejora en la aplicaci&#243;n pr&#225;ctica de los ACG como una posible herramienta para la gesti&#243;n cl&#237;nica en los centros de atenci&#243;n primaria&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">The objective of the study is to obtain the cost&#8217;s relative average weights of the assistance with the retrospective application of the Adjusted Clinical Groups &#40;ACG&#8217;s&#41; in four teams of Primary Care with an attended population in the habitual clinical practice situation&#46;</p> <span class="elsevierStyleSectionTitle">Methods</span><p class="elsevierStyleSimplePara elsevierViewall">Descriptive study of retrospective character&#46; It was included in the study all attended patients by four teams of Primary Care during year 2003&#46; The main measures were&#58; universal variables &#40;age and gender&#41;&#44; dependents &#40;visits and costs&#41; and casuistic and co morbidity&#46; The model of cost per each patient was established differencing the fix costs and the variable ones&#46; Was effected a multiple lineal regression analysis for the prediction of models&#46; The relative cost of each ACG was obtained dividing the average cost of each category among the average cost of each population of reference&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">The total number of the studied patients was 62&#44;311 &#40;intensity of use&#58; 76&#46;7&#37;&#41;&#44; with an average 4&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>3&#46;2 episodes and 7&#46;8<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;5 visits&#47;patient&#47;year&#46; The distribution of costs was 24&#44;135&#44;236&#46;41 &#8364;&#44; 28&#46;9&#37; for fix&#46; The total unitary cost per visit&#47;year was 49&#46;62<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>24&#46;71 &#8364; and the average of the total cost per patient&#47;year 387&#46;34<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>145&#46;87 &#8364; &#40;relative weights of reference&#41;&#46; The explicative power of the classification of ACG was 50&#46;1&#37; in visits and 54&#46;9&#37; for total costs&#46;</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&#46; In case results were confirmed will make possible an improvement in the practice application of ACG as a possible tool for the clinical management in Primary Care centers&#46;</p>"
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Vol. 20. Núm. 2.
Páginas 132-141 (marzo - abril 2006)
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Vol. 20. Núm. 2.
Páginas 132-141 (marzo - abril 2006)
Originales
Open Access
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
Visitas
990
Antoni Sicras-Mainar
Autor para correspondencia
asicras@bsa.gs

Correspondencia: Antoni Sicras Mainar. Badalona Serveis Assistencials, S.A. Gaietà Soler, 6-8. 08911 Badalona. Barcelona. España.
, Josep Serrat-Tarrés
Badalona Serveis Assistencials, S.A., Badalona, Barcelona, España
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Bibliografía
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Resumen
Objetivo

El objeto del estudio es obtener los pesos relativos medios de los costes de la asistencia con la aplicación retrospectiva de los adjusted clinical groups (ACG) en población atendida por equipos de atención primaria en situación de práctica clínica habitual.

Métodos

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.

Resultados

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±24,71 € y el promedio paciente/año de 387,34±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.

Conclusiones

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.

Palabras clave:
Adjusted clinical groups
Pesos relativos
Utilización de recursos
Atención primaria
Abstract
Objective

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.

Methods

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.

Results

The total number of the studied patients was 62,311 (intensity of use: 76.7%), with an average 4.8±3.2 episodes and 7.8±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±24.71 € and the average of the total cost per patient/year 387.34±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.

Conclusions

The ACG are an acceptable system of classification of patients in situation of habitual clinic practice. In case results were confirmed will make possible an improvement in the practice application of ACG as a possible tool for the clinical management in Primary Care centers.

Key words:
Adjusted clinical groups
Relative weights
Resources utilization
Primary care
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Copyright © 2006. Sociedad Española de Salud Pública y Administración Sanitaria
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