Adjusted Clinical Groups Method (ACG) to allocate resources according to the disease burden of each health center

• Published in: Revista medíca de Chile 2016-03, Vol.144 (3), p.291-297
• Main Authors: Santelices C, Emilio, Muñoz P, Fernando, Muñiz, Patricio, Rojas, José
• Format: Article
• Language: Spanish
• Subjects: Chile - epidemiology; Chronic Disease; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; Diagnosis-Related Groups; Female; Health Care Rationing - economics; Heart Failure - diagnosis; Heart Failure - epidemiology; Hospitals, County - economics; Humans; Hypertension - diagnosis; Hypertension - epidemiology; Male; Morbidity; Primary Health Care - economics; Risk Adjustment - methods
• ISSN: 0717-6163
• DOI: 10.4067/S0034-98872016000300003

Health care must be provided with strong primary health care models, emphasizing prevention and a continued, integrated and interdisciplinary care. Tools should be used to allow a better planning and more efficient use of resources. To assess risk adjustment methodologies, such as the Adjusted Clinical Groups (ACG) developed by The Johns Hopkins University, to allow the identification of chronic condition patterns and allocate resources accordingly. We report the results obtained applying the ACG methodology in primary care systems of 22 counties for three chronic diseases, namely Diabetes Mellitus, Hypertension and Heart Failure. The outcomes show a great variability in the prevalence of these conditions in the different health centers. There is also a great diversity in the use of resources for a given condition in the different health care centers. This methodology should contribute to a better distribution of health care resources, which should be based on the disease burden of each health care center.