PMID- 24182966
OWN - NLM
STAT- MEDLINE
DCOM- 20140905
LR  - 20131112
IS  - 1872-6054 (Electronic)
IS  - 0168-8510 (Linking)
VI  - 113
IP  - 1-2
DP  - 2013 Nov
TI  - Resources allocation and health care needs in diabetes care in Danish GP clinics.
PG  - 206-15
LID - S0168-8510(13)00231-5 [pii]
LID - 10.1016/j.healthpol.2013.09.006 [doi]
AB  - BACKGROUND: In several countries, morbidity burdens have prompted authorities to 
      change the system for allocating resources among patients from a 
      demographic-based to a morbidity-based casemix system. In Danish general practice 
      clinics, there is no morbidity-based casemix adjustment system. AIM: The aim of 
      this paper was to assess what proportions of the variation in fee-for-service 
      (FFS) expenditures are explained by type 2 diabetes mellitus (T2DM) patients' 
      co-morbidity burden and illness characteristics. METHODS AND DATA: We use patient 
      morbidity characteristics such as diagnostic markers and co-morbidity casemix 
      adjustments based on resource utilisation bands and FFS expenditures for a sample 
      of 6706 T2DM patients in 59 general practices for the year 2010. We applied a 
      fixed-effect approach. RESULTS: Average annual FFS expenditures were 
      approximately 398 euro per T2DM patient. Expenditures increased progressively 
      with the patients' degree of co-morbidity and were higher for patients who 
      suffered from diagnostic markers. A total of 17-25% of the expenditure variation 
      was explained by age, gender and patients' morbidity patterns. CONCLUSION: T2DM 
      patient morbidity characteristics are significant patient related FFS expenditure 
      drivers in diabetes care. To address the specific health care needs of T2DM 
      patients in GP clinics, our study indicates that it may be advisable to introduce 
      a morbidity based casemix adjustment system.
CI  - Copyright (c) 2013 Elsevier Ireland Ltd. All rights reserved.
FAU - Kristensen, Troels
AU  - Kristensen T
AD  - Institute of Public Health, Centre of Health Economics Research, Faculty of 
      Health Sciences, University of Southern Denmark, J.B. Winslows Vej 9B, DK-5000 
      Odense C, Denmark; Institute of Public Health, Research Unit of General Practice, 
      Faculty of Health Sciences, University of Southern Denmark, J.B. Winslows Vej 9A, 
      DK-5000 Odense C, Denmark. Electronic address: trkristensen@health.sdu.dk.
FAU - Rose Olsen, Kim
AU  - Rose Olsen K
FAU - Sortso, Camilla
AU  - Sortso C
FAU - Ejersted, Charlotte
AU  - Ejersted C
FAU - Thomsen, Janus Laust
AU  - Thomsen JL
FAU - Halling, Anders
AU  - Halling A
LA  - eng
PT  - Journal Article
DEP - 20130925
PL  - Ireland
TA  - Health Policy
JT  - Health policy (Amsterdam, Netherlands)
JID - 8409431
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Comorbidity
MH  - Denmark/epidemiology
MH  - Diabetes Mellitus, Type 2/epidemiology/*therapy
MH  - Diagnosis-Related Groups
MH  - Female
MH  - General Practice/*economics
MH  - Health Expenditures/*statistics & numerical data
MH  - *Health Services Needs and Demand
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Resource Allocation
MH  - Risk Factors
OTO - NOTNLM
OT  - Expenditure variation
OT  - Fee-for-service
OT  - General practice
OT  - Resource utilisation band
OT  - The Johns Hopkins Adjusted Clinical Groups (ACG) System
EDAT- 2013/11/05 06:00
MHDA- 2014/09/06 06:00
CRDT- 2013/11/05 06:00
PHST- 2013/02/11 00:00 [received]
PHST- 2013/09/09 00:00 [revised]
PHST- 2013/09/15 00:00 [accepted]
PHST- 2013/11/05 06:00 [entrez]
PHST- 2013/11/05 06:00 [pubmed]
PHST- 2014/09/06 06:00 [medline]
AID - S0168-8510(13)00231-5 [pii]
AID - 10.1016/j.healthpol.2013.09.006 [doi]
PST - ppublish
SO  - Health Policy. 2013 Nov;113(1-2):206-15. doi: 10.1016/j.healthpol.2013.09.006. 
      Epub 2013 Sep 25.