| Popis: |
OBJECTIVE: To measure with primary data the kinds of family doctor consultations, the reasons for them and the interruptions. DESIGN: Observational, transversal, and multicentred study. SETTING: All the health centres in Area 17 of the Community of Valencia. PARTICIPANTS: Representative sample of 2051 patients belonging to 20 family medicine lists at the 13 health centres in the Area, selected by sampling stratified for health centres and randomised by medical key. MAIN MEASUREMENTS: All the activity occurring during the working day was monitored by an outside observer in the consulting room, who recorded the types of consultation (prior appointment, on-demand, scheduled, urgent, at home, by phone or through a family member) and the reasons for them (as a function of their clinical content for acute pathology, chronic pathology or preventive activities, bureaucraticadministrative reasons or to collect test results). The interruptions to the consultation were recorded. The means, percentages and 95% confidence limits were calculated. RESULTS: Women occasioned 57.5% (95% CI, 55.4-59.6) of demand; and the elderly, 35.9%(33.6%-38.2%). Mean attendance time was 5.38±4.45 minutes. 23.6% (25.4%-21.8%) attended withoutrior appointment; in 14.7%(16.2%-13.2%) a family member attended;6.6% (7.7%-5.5%) were urgent; and 0.7%(1.1%-0.3%) were telephone consultations.65.3% (67.4%-63.2%) of consultations were bureaucratic, and preventive measures were taken only in 3.4% (4.2%-2.6%). 21.8%(23.6%-20%) of patients consulted for clinical + bureaucratic reasons; and 35.5% (37.6%-33.4%), solely for bureaucratic reasons. In 12%(13.4%-10.6%) there were interruptions, mainly for phone calls (3.9%). CONCLUSION: The over-65s caused over a third of all consultations. There was a high attendance without a prior appointment. There were few preventive activities. In consultations, bureaucratic activity takes up more time than clinical activity (care and prevention). |
