Health Promotion Service, Directorate General for Public Health, Canary Islands Health Service, 35003 Las Palmas de Gran Canaria, Spain.
Nursing and Healthcare Research Unit (Investén-isciii), Institute of Health Carlos III, 28029 Madrid, Spain.
Int J Environ Res Public Health. 2022 Apr 1;19(7):4219. doi: 10.3390/ijerph19074219.
Morbidity is the main item in the distribution of expenditure on healthcare services. The Adjusted Morbidity Group (AMG) measures comorbidity and complexity and classifies the patient into mutually exclusive clinical categories. The aim of this study is to analyse the variability of healthcare expenditure on users with similar scores classified by the AMG. Observational analytical and retrospective study. Population: 1,691,075 subjects, from Canary Islands (Spain), aged over 15 years with data from health cards, clinical history, Basic Minimum Specialised Healthcare Data Set, AMG, hospital agreements information system and Electronic Prescriptions. A descriptive, bivariant (ANOVA coefficient η) and multivariant analysis was conducted. There is a correlation between the costs and the weight of AMG (rho = 0.678) and the prescribed active ingredients (rho = 0.689), which is smaller with age and does not exist with the other variables. As for the influence of the AMG morbidity group on the total costs of the patient, the coefficient η (0.09) obtains a median effect in terms of the variability of expenditure, hence there is intra- and inter-group variability in the cost. In a first model created with all the variables and the cost, an explanatory power of 36.43% (R = 0.3643) was obtained; a second model that uses solely active ingredients, AMG weight, being female and a pensioner obtained an explanatory power of 36.4%. There is room for improvement in terms of predicting the expenditure.
发病率是医疗服务支出分布的主要项目。调整发病率群组（AMG）衡量共病和复杂性，并将患者分为互斥的临床类别。本研究的目的是分析按 AMG 分类的具有相似得分的患者的医疗支出的可变性。观察性分析和回顾性研究。人群：来自加那利群岛（西班牙）的 1,691,075 名年龄在 15 岁以上的患者，其数据来自健康卡、临床病史、基本专科医疗数据集、AMG、医院协议信息系统和电子处方。进行了描述性、双变量（ANOVA 系数 η）和多变量分析。AMG 的权重与费用之间存在相关性（rho = 0.678）和规定的活性成分之间的相关性（rho = 0.689），这种相关性随着年龄的增长而减小，与其他变量无关。至于 AMG 发病率组对患者总费用的影响，η 系数（0.09）表示支出变化的中位数效应，因此在成本方面存在组内和组间的变异性。在使用所有变量和成本创建的第一个模型中，获得了 36.43%的解释能力（R = 0.3643）；第二个模型仅使用活性成分、AMG 权重、女性和养老金领取者，获得了 36.4%的解释能力。在预测支出方面还有改进的空间。
