Types of morbidity and categories of patients in a Swedish county - Applying the Johns Hopkins adjusted clinical groups system to encounter data in primary health care

Objective - To elucidate types of morbidity and categories of patients in a large population. Design - A one-year retrospective study of encounter data from electronic patient record databases in primary health care, with application of the Johns Hopkins Adjusted Clinical Groups System. Setting - Blekinge County Council, southeastern Sweden, with 149 552 inhabitants. Subjects - All patients with a diagnosis-registered encounter with a GP in 2002 at 13 publicly managed PHC centres. Main outcome measures - Anonymous identification number, age, gender, type of morbidity (Aggregated Diagnostic Groups), and category of patient (Adjusted Clinical Groups). Results - About 45% of the county's inhabitants had at least one diagnosis-registered encounter with a GP during the year. The most common types of morbidity were "time limited'' (24.0% of all types), "likely to recur'' (19.6%), and "signs/symptoms'' (19.0%). About 33.3% of all patients had one and only one time-limited condition, about 16.8% had one and only one recurring condition, and about 12.1% of the patients had only a chronic condition. Conclusion - Types of morbidity in primary health care are dominated by nearly equal proportions of "time limited'', "likely to recur'', "chronic'', and "signs/symptoms''. The predominant categories of patients are those with only one type of morbidity, while about one-third of the patients had a constellation of two or more types of morbidity during a one-year period.