Troels Kristensen1, Kim Rose Olsen, Camilla Sortsø, Charlotte Ejersted, Janus Laust Thomsen, Anders Halling. 1. Institute of Public Health, Centre of Health Economics Research, Faculty of Health Sciences, University of Southern Denmark, J.B. Winsløws 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. Winsløws Vej 9A, DK-5000 Odense C, Denmark. Electronic address: trkristensen@health.sdu.dk.
Abstract
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.
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.
Authors: Peder Ahnfeldt-Mollerup; Jesper Lykkegaard; Anders Halling; Kim Rose Olsen; Troels Kristensen Journal: BMC Health Serv Res Date: 2016-04-06 Impact factor: 2.655
Authors: Troels Kristensen; Frans Boch Waldorff; Jørgen Nexøe; Christian Volmar Skovsgaard; Kim Rose Olsen Journal: Int J Environ Res Public Health Date: 2017-11-09 Impact factor: 3.390
Authors: Shelley-Ann M Girwar; Marta Fiocco; Stephen P Sutch; Mattijs E Numans; Marc A Bruijnzeels Journal: BMC Health Serv Res Date: 2021-03-10 Impact factor: 2.655
Authors: Shelley-Ann M Girwar; Robert Jabroer; Marta Fiocco; Stephen P Sutch; Mattijs E Numans; Marc A Bruijnzeels Journal: Health Sci Rep Date: 2021-07-23