Clinical categories of patients and encounter rates in primary health care - a three-year study in defined populations.
BACKGROUND
The objective was to estimate the proportion of inhabitants with a diagnosis-registered encounter with a general practitioner, and to elucidate annual variations of clinical categories of patients in terms of their individual comorbidity.


METHODS
A three-year retrospective study of encounter data from electronic patient records, with an annual-based application of the Johns Hopkins Adjusted Clinical Groups (ACG) system. Data were retrieved from every patient with a diagnosis-registered encounter with a GP during the period 2001-2003 at 13 publicly managed primary health care centres in Blekinge county, southeastern Sweden, with about 150000 inhabitants.


METHODS
Proportions of inhabitants with a diagnosis-registered encounter, and ranges of the annual proportions of categories of patients according to ACGs.


RESULTS
The proportion of inhabitants with a diagnosis-registered encounter ranged from about 64.0% to 90.6% for the primary health care centres, and averaged about 76.5% for all inhabitants. In a three-year perspective the average range of categories of patients was about 0.4% on the county level, and about 0.9% on the primary health care centre level. About one third of the patients each year had a constellation of two or more types of morbidity.


CONCLUSIONS
About three fourths of all inhabitants had one or more diagnosis-registered encounters with a general practitioner during the three-year period. The annual variation of categories of patients according to ACGs was small on both the county and the primary health care centre level. The ACG system seems useful for demonstrating and predicting various aspects of clinical categories of patients in Swedish primary health care.
Center for Family and Community Medicine, Neurotec Department, Karolinska Institutet, Stockholm, Sweden. lennart.carlsson@chello.se
Lennart
L
Carlsson
Lars-Erik
LE
Strender
Gerd
G
Fridh
Gunnar H
GH
Nilsson
D000208:Acute Disease / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology; D003151:Community Health Centers / Q000458:organization & administration / Q000706:statistics & numerical data*; D015897:Comorbidity; D003953:Diagnosis-Related Groups / Q000706:statistics & numerical data; D005194:Family Practice / Q000706:statistics & numerical data*; D006801:Humans; D016347:Medical Records Systems, Computerized; D011320:Primary Health Care / Q000458:organization & administration* / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012984:Software; D013548:Sweden / Q000453:epidemiology