Primary-care-based episodes of care and their costs in a three-month follow-up in Finland

Objective To explore patient characteristics, resource use, and costs related to different episodes of care (EOC) in Finnish health care.Design Data were collected during a three-month prospective, non-randomized follow-up study (Effective Health Centre) using questionnaires and an electronic health record.Setting Three primary health care practices in Pirkanmaa, Finland.Subjects Altogether 622 patients were recruited during a one-week period. Inclusion criteria: the patient had a doctor's or nurse's appointment on the recruiting day and agreed to participate. Exclusion criteria: patients visiting a specialized health guidance clinic for pregnant women, children, and mothers.Main outcome measures Patient characteristics, resource use, and costs based on the ICPC-2 EOC classification.Results On average, the patients had 1.22 EOCs during the three months. Patient characteristics and resource use differed between the EOC chapters. Chapter L, Musculoskeletal, had the most episodes (17%). The most common (8%) single EOC was upper respiratory infection. The mean cost of an episode (COE) was Euro389.56 (standard error 61.11) and the median COE was Euro165.00 (interquartile range Euro118.46-288.56) during the three-month follow-up. The most expensive chapter was K, Circulatory, with a mean COE of Euro909.85. The most expensive single COE was in chapter K, Euro32 545.56. The most expensive 1% of the COEs summed up covered 36% of the total COEs.Conclusion Patient characteristics, resource use, and costs differed between the ICPC-2 chapters, which could be taken into account in service planning and pricing. Future studies should incorporate more specific diagnoses, larger data sets, and longer follow-up times.