Risk-Adjusted Models of Costs Referable to General Practitioners Based on Administrative Databases in the Friuli Venezia Giulia Region in Northern Italy
Abstract:Objective: To develop risk adjustment models for cost evaluation in primary health care in Italy based on administrative databases.
Setting:The 2007 administrative databases from the National Health Service of the Friuli Venezia Giulia Region were the data source. Data referred to the general population and included information on the use of health services (inpatient, outpatient, medication, home care) as well as on the major chronic health problems. Data included persons who, for their health condition, must… Show more
“…Such a model misspecification might lead to nonhorizontal equity, in which patients in equal need would not receive the same health care because of unequal allocation of the resources [18,19]. Although some LHAs have adopted ACG or other adjustment scores, they recalibrate the scores using administrative databases [20] that are unable to capture many of the clinical entities that pertain specifically to the primary care setting. In addition, these local data sources are not representative of the general population.…”
The HSM Index is a reliable case-mix system that could be implemented in general practice for costs adjustment. This tool should ensure fairer scrutiny of resource use and allocation of budgets among general practitioners.
“…Such a model misspecification might lead to nonhorizontal equity, in which patients in equal need would not receive the same health care because of unequal allocation of the resources [18,19]. Although some LHAs have adopted ACG or other adjustment scores, they recalibrate the scores using administrative databases [20] that are unable to capture many of the clinical entities that pertain specifically to the primary care setting. In addition, these local data sources are not representative of the general population.…”
The HSM Index is a reliable case-mix system that could be implemented in general practice for costs adjustment. This tool should ensure fairer scrutiny of resource use and allocation of budgets among general practitioners.
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