title: Primary-care-based episodes of care and their costs in a three-month follow-up in Finland.
abstract: OBJECTIVE
  To explore patient characteristics, resource use, and costs related to different episodes of care (EOC) in Finnish health care.
  
  
  METHODS
  Data were collected during a three-month prospective, non-randomized follow-up study (Effective Health Centre) using questionnaires and an electronic health record.
  
  
  METHODS
  Three primary health care practices in Pirkanmaa, Finland.
  
  
  METHODS
  Altogether 622 patients were recruited during a one-week period. Inclusion criteria: the patient had a doctor's or nurse's appointment on the recruiting day and agreed to participate. Exclusion criteria: patients visiting a specialized health guidance clinic for pregnant women, children, and mothers.
  
  
  METHODS
  Patient characteristics, resource use, and costs based on the ICPC-2 EOC classification.
  
  
  RESULTS
  On average, the patients had 1.22 EOCs during the three months. Patient characteristics and resource use differed between the EOC chapters. Chapter L, "Musculoskeletal", had the most episodes (17%). The most common (8%) single EOC was "upper respiratory infection". The mean cost of an episode (COE) was €389.56 (standard error 61.11) and the median COE was €165.00 (interquartile range €118.46-288.56) during the three-month follow-up. The most expensive chapter was K, "Circulatory", with a mean COE of €909.85. The most expensive single COE was in chapter K, €32 545.56. The most expensive 1% of the COEs summed up covered 36% of the total COEs.
  
  
  CONCLUSIONS
  Patient characteristics, resource use, and costs differed between the ICPC-2 chapters, which could be taken into account in service planning and pricing. Future studies should incorporate more specific diagnoses, larger data sets, and longer follow-up times. Key points The most common episodes were under the ICPC-2 "Musculoskeletal" chapter, but the highest mean and single-episode costs were related to the "Circulatory" chapter. The mean (median) cost of episodes that started in primary care was €390 (€165) during the three-month follow-up. Patient characteristics, resource use, and costs differed significantly between the ICPC-2 chapters. The most expensive 1% of the episodes covered 36% of the total costs of all the episodes.
authors.affiliation: a School of Medicine , University of Tampere , Tampere , Finland ;
authors.forename: J
authors.initials: J
authors.lastname: Heinonen
authors.affiliation: b Department of General Practice , University of Tampere , Finland ;
authors.forename: T H
authors.initials: TH
authors.lastname: Koskela
authors.affiliation: c ESiOR Oy , Kuopio , Finland.
authors.forename: E
authors.initials: E
authors.lastname: Soini
authors.affiliation: d Faculty of Health Sciences , University of Eastern Finland , Finland ;|e Unit of Primary Health Care , Kuopio University Hospital , Finland.
authors.forename: O P
authors.initials: OP
authors.lastname: Ryynänen
mesh_terms: D000328:Adult; D000368:Aged; D057286:Electronic Health Records; D017050:Episode of Care; D005260:Female; D005387:Finland; D005500:Follow-Up Studies; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000191:economics / Q000706:statistics & numerical data*; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Costs and cost analysis; Finland; episode of care (EOC); general practice; health care costs; primary health care (PHC); resource allocation