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Background: There are some health care centers in Region Västmanland that always turn a profit, and other health care centers which always go at a loss.  

Aim: The aim of this study was to analyze the potential reasons as to why the same health care centers always profit, and the other health care centers always go at a loss under year 2022.  

Methods: A cross-sectional study with register data for the year 2022 was used as a method. The analysis was performed by aggregating different indicators and measures. For example, the age and sex of the patients, socioeconomic status, morbidity, and number of listed patients that the health centers have. Two different therapy areas were chosen for deeper analysis - diabetes and atrial fibrillation. Medicines for these diagnoses have the highest cost for the health centers. In addition to this, differences between the health care centers in prescribing of over-the-counter medicines and in selection of generic drugs were also considered. 

Results: The results show that the three health centers that lost the most had 29 percent higher costs per diabetes patient of the more expensive diabetes drugs compared to other three health centers that always make a profit. The health centers that had the largest loss had higher costs of Lyrica, a more expensive drug compared to other bioequivalent drugs, than the other health centers. The health centers that lost the most had older patients, and more patients who were socioeconomically disadvantaged. Two of the health centers that lost the most had higher CNI scores, which means that the patients at these health centers had a lower socio-economic status.  

In conclusion, the health care centers that lost the most had the highest diabetes costs, especially from the more expensive drugs and they had also more older patients.