Together with his colleague Henrietta Arwin, who is also the primary care manager in Gothenburg, Åsa Lind welcomes the inquiry, but is at the same time surprised at the result. Before the investigation was started, the managers say that no indications had been given that the system was being used incorrectly.

- We have already put in educational efforts and will discuss this more so that it will be right, says Henrietta Arwin, who in addition to being the manager is also a specialist physician in general medicine.

Heavier diagnoses give more money

In the Västra Götaland region, a system called ACG (Adjusted Clinical Group) is used. It is a points system that gives more money in compensation to the current health care center based on diagnosis, expected care, medicines and visits. Heavier and more diagnoses thus make more money.

The Västra Götaland region has reviewed 29 health centers and 4,500 medical records and seen how well primary care follows the guidelines for diagnosis.

A small majority, 58 percent of the journal entries reviewed, were judged to have a correct diagnosis record. Thus, almost half were inaccurate and eight health centers were deliberately judged to have recorded diagnoses that patients had, but which were not essential at the time of care.

- For example, chronic diagnoses have been registered in the journal when sending out test replies, says Åsa Lind, who wants to clarify that you are usually reimbursed for a diagnosis every fifteen months and to register more often does not have to mean more money.

Why then have you been like this?

- One explanation is that there was a lack of knowledge and that you feel that you had previously had too low ACG compensation in terms of the weight of care the patients have. It is therefore believed that you can get diagnoses for your listed patients in a journal and that this is corrected in this way. They wanted to give their patients the best care.

Changed working methods

Both Henrietta Arwin and Åsa Lind say that all the heads of operations for the relevant health centers have now changed their working methods and are following the guidelines and that they are no longer systematically registering diagnoses.


In the clip below you can hear more about how the health centers have done wrong:

Play

Review reveals: How nursing centers are messing with medical records - to get higher compensation Photo: TT / Västra götalandsregionen