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espanolIntroduccion. La hiperfrecuentacion de las consultas causa un gran impacto en el Sistema Sanitario. Nos planteamos describir al paciente hiperfrecuentador y evaluar el efecto de una intervencion sobre los hiperfrecuentadores (HF) que seguian siendolo despues de 2 anos. Material y Metodos. Fase 1- Descriptivo hiperfrecuentacion de consultas medicas en un Centro de Salud urbano; variables: frecuentacion, socio-demograficas, cronicidad, y tipologia (segun motivo de hiperfrecuentacion). Fase 2- Con los HF que seguian siendolo despues de 2 anos se hizo un estudio cuasi-experimental, pre y post-intervencion sobre muestra sistematica y de conveniencia de pacientes, comparando los resultados con otros 29 pacientes sobre los que no se intervino. Resultados. El 5,4 % de los consultantes fueron HF. El 90 % pertenecia a la tipologia de problemas organicos, o de sospecha enfermedad mental. El 87 % tenia enfermedades cronicas o trastorno mental. A los 2 anos un 25,5 % seguia siendo HF, y fueron denominados HF-Persistentes (HF-P). Tras 5 meses de intervencion sobre HF-P, la hiperfrecuentacion disminuyo en el grupo en que se intervino y en el que no; las diferencias fueron estadisticamente significativas y el promedio anual paso de 21,4 a 9,5 en el grupo intervenido y de 21,4 a 10,8 en el otro. No se encontraron diferencias estadisticamente significativas entre el grupo de intervencion y el de no-intervencion. Conclusiones. Los HF hallados lo fueron en un porcentaje algo menor del encontrado en la literatura. La intervencion no supuso una disminucion de la hiperfrecuentacion superior a la observada de manera espontanea en el grupo no-intervenido, pero en ambos si disminuyo en el periodo pre y post-intervencion, probablemente tras haber introducido cambios organizativos. Los pacientes HF fueron dejando de serlo a lo largo del tiempo. EnglishIntroduction. Frequent attendance has a vast impact on the Health System. Our purpose was to describe frequent users and to evaluate the effect of an intervention on those who had remained being frequent users for two years. Material and methods. A descriptive study of frequent attenders of medical consultations in an urban Healthcare Centre: sociodemographic items, chronicity and typology (depending on the main cause of their frequent attendance). A quasi-experimental study was made, pre and post intervention, on a systematic and convenient sample of 29 patients among those patients who still remained being frequent users after two years. Results were compared with another 29 patients who had not received any intervention. Results. 5.4% of the total Healthcare Centre users were frequent attenders. 90% of which were classified into biological or psychological groups. 87% had either chronic illnesses or mental illnesses. After two years, 25.5% were still frequent users (HF-P). After 5 months from the beginning of the intervention on HF-P, the frequent attendance rate of both the intervention and the control group declined with meaningful differences going from 21.4 to 9.5 in the intervention group and from 21.4 to 10.8 in the another group. However, neither the mean nor the median of attendance were significantly different between the intervention group and the non-intervention group. Conclusions. The frequent attendance rate in this study represented a slightly lower percentage than that found in other studies. The intervention did not entail a wider decrease in the frequent attendance rate than that observed spontaneously in the non-intervention group, but the attendance decreased in both groups during the period pre and post intervention, perhaps due to the fact of having introduced some organizational changes in the Healthcare Centre. The rate of frequent users was slowly descending along the time. |
