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Episodes of Care: To Include Primary Care is the Challenge

Department of Public Health, P.O. Box 41, 00014 University of Helsinki, Finland outi.elonheimo{at}helsinki.fi

M. Linna, PhD

National Research and Development Centre for Welfare and Health, Finland, Sosiaali- ja terveyspalvelut, P.O. Box 220, 00531 Helsinki, Finland miika.linna{at}stakes.fi

M. Brommels, MD PhD

Department of Public Health, P.O. Box 41, 00014 University of Helsinki, Finland and Medical Management Centre, Karolinske Institute, 171 77 Stockholm, Sweden

Population-based analysis and planning of health services should ideally cover all service utilization, with seamless care processes (across provider boundaries) as the observational units. The basic tool needed is an episode of care classification. Although hospital care has routinely been registered in computerized databases for decades, primary care has only recently been able to provide comparable patient data in an easily accessible form. We have designed a simple disease category system, which is easy to apply in routine registration in primary care, and which can be used in order to classify episodes of care. We have tested the feasibility of the approach by analysing one year of data in a data warehouse covering all health service utilization by citizens in the city of Helsinki, a total of over 4 million encounters. Results displayed, representing a small number of reports produced, include the treatment costs and volumes of the care episodes as classified in disease categories across health districts, and detailed analysis of `gross consumers' (patients with an annual treatment cost in excess of EUR 20,000), and patients treated in hospitals or long-term institutions.

Key Words: Disease categories • episodes of care • population-based planning • primary care

Health Informatics Journal, Vol. 9, No. 2, 103-109 (2003)
DOI: 10.1177/1460458203009002005


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