[Impact of Morbidity on Health Care Costs of a Department of Health through Clinical Risk Groups. Valencian Community, Spain].
BACKGROUND
Risk adjustment systems based on diagnosis stratify the population according to the observed morbidity. The aim of this study was to analyze the total health expenditure in a health area, relating to age, gender and morbidity observed in the population.


METHODS
Observational cross-sectional study of population and area of health care costs in the Health District of Denia-Marina Salud (Alicante) in 2013. Population (N=156,811) were stratified by Clinical Risk Groups into 9 states of health, state 1 being healthy, and state 9 the highest disease burden. Each inhabitant was charged with the hospital costs, primary care and outpatient pharmacy to obtain the total costs. Health status and severity by age and gender, as well as the costs of each group were analysed. The statistical tests, student t and χ2 were applied to verify the existence of significant differences between and intra groups.


RESULTS
The average cost per inhabitant was 983 euros which increased from 240 euros to 42,881 at the state 9 and severity level 6. Patients of health states 5 and 6 caused the largest expenditure by concentration of the population, but health states 8 and 9 had the highest average expenditure, with 80% of hospitalised cost.


CONCLUSIONS
A different composition of health expenditure per individual morbidity was corroborated, with an exponential growth in hospital spending.
Centro de Ingeniería Económica. Universitat Politècnica de València. Valencia.
Vicent
V
Caballer Tarazona
Centro de Ingeniería Económica. Universitat Politècnica de València. Valencia.nguadala@omp.upv.es.
Natividad
N
Guadalajara Olmeda
Centro de Ingeniería Económica. Universitat Politècnica de València. Valencia.
David
D
Vivas Consuelo
Hospital Marina Salud. Denia. Alicante..
Antonio
A
Clemente Collado
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003365:Costs and Cost Analysis; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000191:economics*; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006304:Health Status; D017721:Hospital Costs / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013030:Spain; D055815:Young Adult
Community Health Planning; Cost analysis; Economics, Pharmaceutical; Emergency Service, Hospital; Healths Economics; Hospital Costs; Morbidity; Primary health care; Risk Adjustment; Spain