[Analysis of the claims in a specialist primary care center]. / Análisis de las reclamaciones en un centro de atención primaria de salud de especialidades.

OBJECTIVE: To analyze the written claims attended at a specialists unit of a Primary Health Care Center in Nou Barris, Barcelona. DESIGN: Evaluative observational study. SETTING: Health Care District of Nou Barris, with a population of 170,849. Period of study covers claims attended between 1-6-1996 to 31-12-1998. PARTICIPANTS: 220 claims registered at a specialist unit of a primary health care center. MEASUREMENTS: Claimer's age and gender, heath care net of origin, claim's motive, claimed person or service and health care activity. Statistical analyses performed included descriptive techniques and Khi-square (chi 2) tests (alpha = 0.05). RESULTS: Cumulative incidence of claims was 4.03 per 10,000 person-year in 1996, 4.70 in 1997 and 5.88 in 1998 (p = 0.0128). 220 claims were analyzed, 53.1% of them came from women. Mean age was 51.12 +/- 15.8 years. 60% of claims came from people using the traditional health care net, and 40% from reformed health care net. Mean time of response was 12.3 +/- 12.7 days. Ophthalmology was the most claimed service (18.64%), followed by "the system" (13.64%), and "the center" (13.64%). 64% of claims pointed to specialists, and don't adjusted with their health care activity (p = 0.0001). Relative risk of being claimed at the specialists unit was 2.91, compared to the rest of the primary health care centers of Nou Barris in 1998. CONCLUSIONS: Health care user's claims become useful to detect some difficult aspects. However, improvements in the methodology of their evaluation are needed.

Análisis de las reclamaciones en un centro de atención primaria de salud de especialidades / Analysis of claims to specialists in a primary health care center

Objetivo. Analizar las reclamaciones presentadas en la Unidad de Atención al Usuario del Centro de Atención Especializada de la Dirección de Atención Primaria (DAP) Nou Barris de Barcelona ciudad. Diseño. Investigación evaluativa observacional. Emplazamiento. DAP de Nou Barris que atiende una población de 170.849 personas, según datos censales de 1996. El período de estudio comprende las reclamaciones presentadas entre el 1 de junio de 1996 y el 31 de diciembre de 1998. Participantes. Cada una de las 220 reclamaciones registradas en el centro de atención especializada. Mediciones. Edad y género del demandante, modelo asistencial de procedencia, motivo de la reclamación, persona o servicio reclamado y actividad de la consulta. Se ha utilizado la descripción estadística y las pruebas de ji-cuadrado (*2) pertinentes. El riesgo * ha sido del 5 por ciento. Resultados. La incidencia acumulada del número de reclamaciones ha sido de 4,03 por 10.000 personas-año en 1996, de 4,70 en 1997 y de 5,88 en 1998 (p = 0,0128). De las 220 reclamaciones registradas, un 53,1 por ciento corresponde a mujeres. La edad media es de 51,12 ñ 15,80 años. El 60 por ciento de las reclamaciones proviene de la asistencia no reformada y el 40 por ciento de la reformada. El tiempo medio de demora en la respuesta es de 12,3 ñ 12,7 días. Las reclamaciones más frecuentes van dirigidas a oftalmología (18,64 por ciento), al sistema (13,64 por ciento) y al centro (13,64 por ciento). El 64 por ciento de las reclamaciones van dirigidas a médicos especialistas y no se ajustan a la actividad asistencial desarrollada (p = 0,0001). El riesgo relativo de presentar reclamaciones en el centro de atención especializada fue de 2,91 respecto del resto de centros de la DAP Nou Barris en 1998. Conclusiones. Las reclamaciones de los usuarios de la atención primaria de salud son un instrumento útil para detectar algunos aspectos conflictivos. Sin embargo, hay que mejorar la metodología de evaluación de las mismas (AU)

[Factors conditioning absenteeism among primary care physicians]. / Factores condicionantes del absentismo laboral entre los médicos de atención primaria.

OBJECTIVES: To find whether the variables age, gender, speciality, training and type of contract of primary care doctors, as well as the size of their patient lists and the sort of centre where they work, affect their absenteeism, as measured by time off work sick. DESIGN: An observational, crossover study. SETTING: Nou Barris, sub-division of Barcelona City, primary care (PC) district during 1994. PARTICIPANTS: Doctors. MEASUREMENTS AND MAIN RESULTS: In the PC district there were 121 doctors, counting PC teams (PC), traditional system (TS) and specialists. Bivariant epidemiological and statistical techniques were used to verify the relationships between variables. Alpha risk was 5%. 40% of the District's doctors had some time off sick during the year. There were 79 occasions of time off (74 were for short-term sickness and 5 for maternity). Total days lost were 2,477, an average of 31.35. Time off work was related to the age of the doctors and the number of patients attending. Centres where the reform had been implemented had very few cases of time off. CONCLUSIONS: Cases of time off work for sickness among primary care doctors are mainly concentrated in the non-reformed network. It would be useful to study ways of increasing these doctors' motivation.