Heart failure in primary care: co-morbidity and utilization of health care resources
| Autor: | Pilar García-Sagredo, José Luis Monteagudo, Ángel Alberquilla, Fernando López-Rodríguez, Montserrat Carmona, Mario Pascual, Luis García-Olmos, Adolfo Muñoz, Carlos H. Salvador, Angel Otero-Puime |
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| Přispěvatelé: | Ministerio de Ciencia e Innovación (España), Ministerio de Sanidad y Consumo (España), Centro de Transferencia de Tecnología e Innovación (España), Instituto de Salud Carlos III |
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Prescription drug Prescription Drugs Cross-sectional study Office Visits General Practice Co-morbidity Primary care Comorbidity Efficiency Resource utilization resource utilization Drug Costs primary care Nursing Health care medicine ACG Humans Practice Patterns Physicians' co-morbidity Primary nursing Aged Heart Failure Data collection Primary Care Nursing Primary Health Care business.industry Middle Aged Cross-Sectional Studies Spain Family medicine Health Resources Original Article Co morbidity Christian ministry Female Family Practice business |
| Zdroj: | Repisalud Instituto de Salud Carlos III (ISCIII) Family Practice |
| Popis: | BACKGROUND: In order to ensure proper management of primary care (PC) services, the efficiency of the health professionals tasked with such services must be known. Patients with heart failure (HF) are characterized by advanced age, high co-morbidity and high resource utilization. OBJECTIVE: To ascertain PC resource utilization by HF patients and variability in the management of such patients by GPs. METHODS: Descriptive, cross-sectional study targeting a population attended by 129 GPs over the course of 1 year. All patients with diagnosis of HF in their clinical histories were included, classified using the Adjusted Clinical Group system and then grouped into six resource utilization bands (RUBs). Resource utilization and Efficiency Index were both calculated. RESULTS: One hundred per cent of patients with HF were ranked in RUBs 3, 4 and 5. The highest GP visit rate was 20 and the lowest in excess of 10 visits per year. Prescription drug costs for these patients ranged from €885 to €1422 per patient per year. Health professional efficiency varied notably, even after adjustment for co-morbidity (Efficiency Index Variation Ratio of 28.27 for visits and 404.29 for prescription drug cost). CONCLUSIONS: Patients with HF register a high utilization of resources, and there is great variability in the management of such patients by health professionals, which cannot be accounted for by the degree of case complexity. Funding: This study was partially supported by a CENIT Programme (MICINN-CDTI) [CEN-2007-1010 “Digital personal environment for health and well-being – AmiVital” project]; by a grant from the Ministry of Health and Consumer Affairs [FIS PI08-0435]. The funders had no role in the study design, data collection and data analysis, decision to publish or drafting of the manuscript. Sí |
| Databáze: | OpenAIRE |
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