[Articles from Castilla-La Mancha, of primary health care interest, published in national journals. Review of 5 years (1986-1990)]. / Artículos de Castilla-La Mancha, de interés en atención primaria de salud, publicados en revistas nacionales. Revisión de cinco años (1986-1990).

The publications cover the research undertaken and express the scientific level of a community or of a field of study. To describe the scientific development of Primary Health Care (PHC) in Castilla-La Mancha (CLM), 71 projects carried out in the area are studied. These projects were found in seven national magazines, through a survey of the period 1986-1990. Of these, variants in both authors and articles have been studied. 44% are in Primary Care. There are 141 authors (only two with greater than 10 articles). Professionals working in Health Centres participate in 31 articles (44%). The subject most commonly dealt with is that of drugs. 58% of the bibliographical references fall within the previous 5 years. 83% are "originals" and "letters to the editor"; of these, 71% use descriptive and 22% analytical methods. 39% use inferential statistics. The results have confirmed Bradford and Lotka's bibliometric laws. Those in the scientific community of CLM who have researched into PHC do not appear to differ from any other research groups. A greater use of analytical methods would raise the scientific level of PHC.

[Drug prescription in primary care. Pharmacoepidemiologic study in the Albacete area]. / Prescripción de medicamentos en Atención Primaria. Estudio fármacoepidemiológico en el área de Albacete.

Prescribing medication is a clinical procedure used quite often in Primary Care (PC). The quality of some prescriptions in the province of Albacete is studied, evaluating the characteristics of the PC physicians. The bottles of Cephalosporins, broad-spectrum Penicillins, Rawolfias, Diuretics, Beta-Blockers and Cerebral Blood Vessel Dilating Medications have been analyzed. Respectively, 38.4%, 30.8% and 28.5% of the physicians prescribed antibiotics, antihypertensives and blood vessel dilating medications acceptably. The logistic regression analysis only reveals a slight indication of: a better prescribing of antibiotics (p less than 0.02) at an older age, when employed in an urban environment and having a smaller number of patients to care for; and a better prescribing of cerebral blood vessel dilating medications (p less than 0.05) for specialists by way of MIR. The commercial information on medications could standardize behaviour with regard to writing prescriptions. To improve quality, it would be necessary to improve the scientific attitude of health care professionals.

[Child vaccination coverage in a rural community: prevalence and related factors]. / Cobertura vacunal infantil en una comunidad rural: prevalencia y factores asociados.

In the rural environment investigations on vaccination coverage during the daily consultation of Primary Care is feasible. For knowing the real levels and improve the situation, infant vaccination coverage was studied in a rural township with hamlet (small villages) by interviewing the parents and checking the vaccination card. Demographics variables were also analysed looking for different coverage according to these characteristics. One hundred and five children from 0 to 14 years were studied. Relative risks were calculated for the situation of no vaccination. The 69% have got vaccination card. Vaccination rates for Tetanus, Oral Polio, Triple Virus (Measles, Rubella, Mumps) and Rubella (73.3%, 73.3%, 75.5% and 83.3% respectively) were not enough for its eradication. The older children and those who have the biggest family size, showed less rates. Those who live in hamlets have a greater risk to not to be vaccinate, being able to perform "bags" of the deficient vaccination. This survey has allowed to get a complete register of infant vaccination coverage and start correcting actions of the deficiencies noticed.

[Impact of the development of a rural health center on the demand for emergency care]. / Impacto sobre la demanda de asistencia urgente tras la puesta en marcha de un centro de salud rural.

The new legislation on Primary Health Care (PHC) has reorganized the implementation of services. We have evaluated the impact on the demand of emergency attention in the rural town of Almodóvar del Pinar (Cuenca); this attention was previously given by the APD physician and now partially depends from the Health Center. Overall 97 cases were assisted, as compared with 229 in the preceding period (p less than 0.001). The motives for consultation remained unchanged, as well as the timing of the demand. The home visits were significantly reduced (p less than 0.05). The reduction might be explained on the basis of the moving away of the clinic location and the increased health education. The reduction in home visits might be accounted for by a higher attendance to the Health Center as this is believed to be better equipped. Hospital referral remained unchanged, 90% of cases being managed at local level. The emergency attention facilities in rural areas should be better equipped.