Análisis de la prescripción inducida en una comarca de atención primaria / Analysis of the induced prescription in a primary care region

Objetivos. Conocer la prevalencia, el origen y el gasto atribuible de la prescripción inducida (PI) en atención primaria (AP) en la Comarca Oeste de Gipuzkoa, determinar el grado de acuerdo de los médicos de AP con respecto a la PI y analizar la adecuación de la PI a los indicadores del contrato de gestión clínica de la AP. Material y métodos. Diseño: estudio descriptivo, transversal y multicéntrico. Ámbito: AP, 38 médicos pertenecientes a 17 unidades de AP de la Comarca Oeste de Gipuzkoa. Participantes: prescripciones farmacéuticas financiables realizadas durante 2 días en consulta a demanda y crónicas generadas por el programa informático Osabide. Variables analizadas: tipo de prescripción, origen, especialidad del prescriptor, diagnóstico, precio y grado de acuerdo. Resultados. Se realizaron 6.919 prescripciones y el 44% fueron PI (intervalo de confianza del 95%: 42,8–45,1). El 62,2% del gasto total se atribuyó a la PI, con un precio medio por receta de 22,3€ para la PI y de 10,6€ para la prescripción propia. Los subgrupos terapéuticos de mayor gasto fueron los hipolipidemiantes y los broncodilatadores. Resultados. El grado de desacuerdo de los médicos participantes con la PI fue del 28,8%. La adecuación de los indicadores de calidad de la prescripción fue mayor en la prescripción propia que en la PI. Conclusiones. Existe un porcentaje elevado de PI asociado a un gasto elevado que se atribuye a la AP. El porcentaje de desacuerdo en AP con respecto a la PI es importante. Se observa una influencia elevada de la PI en la evaluación de los indicadores de calidad establecidos en la AP(AU)

Objectives. To find out the prevalence, origin and cost associated with Induced Prescription (IP) in Primary Health Care (PHC) in the West of Gipuzkoa (WG). To find out the extent to which PHC doctors agree with IP. To analyse the adaptation of IP to PHC clinical management contract indicators. Materials and methods. Design descriptive multi-centre cross-study. Location. Primary Health Care, 38 doctors from 17 WG PHC units. Participants. Pharmaceutical prescriptions eligible for finance over a period of two days in outpatients and chronic diseases generated by the Osabide computer application. Participants. Variables analysed: type of prescription, origin, prescriber, diagnosis, price and level of agreement. Results. A total of 6.919 prescriptions were made out, with 44% (95% CI: 42.8–45.1) being IP. Of the total cost, 62.2% was put down to IP, with an average price per prescription of €22.3,and in non-induced prescription (NIP) it was €10.62. The therapeutic subgroups with the highest cost were lipid lowering and bronchodilator drugs. The level of disagreement of the doctors taking part in IP was 28.8%. The adaptation to the quality indicators of the prescription was higher in NIP than in IP. Conclusions. There is a high percentage of IP associated with high costs attributed to PHC. The percentage of disagreement in PHC with regard to IP is significant. There is a high influence of IP on the evaluation of the quality indicators established in PHC(AU)

[Analysis of the induced prescription in a primary care region]. / Análisis de la prescripción inducida en una comarca de atención primaria.

OBJECTIVES: To find out the prevalence, origin and cost associated with Induced Prescription (IP) in Primary Health Care (PHC) in the West of Gipuzkoa (WG). To find out the extent to which PHC doctors agree with IP. To analyse the adaptation of IP to PHC clinical management contract indicators. MATERIALS AND METHODS: Design descriptive multi-centre cross-study. LOCATION: Primary Health Care, 38 doctors from 17 WG PHC units. PARTICIPANTS: Pharmaceutical prescriptions eligible for finance over a period of two days in outpatients and chronic diseases generated by the Osabide computer application. Variables analysed: type of prescription, origin, prescriber, diagnosis, price and level of agreement. RESULTS: A total of 6.919 prescriptions were made out, with 44% (95% CI: 42.8-45.1) being IP. Of the total cost, 62.2% was put down to IP, with an average price per prescription of €22.3,and in non-induced prescription (NIP) it was €10.62. The therapeutic subgroups with the highest cost were lipid lowering and bronchodilator drugs. The level of disagreement of the doctors taking part in IP was 28.8%. The adaptation to the quality indicators of the prescription was higher in NIP than in IP. CONCLUSIONS: There is a high percentage of IP associated with high costs attributed to PHC. The percentage of disagreement in PHC with regard to IP is significant. There is a high influence of IP on the evaluation of the quality indicators established in PHC.