Las familias de la crisis en las consultas pediátricas de Atención Primaria: estudio descriptivo observacional / Families of the economic crisis in paediatric Primary Care clinics: descriptive observational study

OBJETIVO: Estudiar el impacto de la crisis económica sobre las familias de los niños que acuden a las consultas de Atención Primaria y su relación con el nivel socioeconómico. PACIENTES Y MÉTODOS: Estudio descriptivo observacional mediante cuestionario. Se han recogido 453 encuestas de niños entre 1 y 7 años de edad pertenecientes a 4 consultas de Atención Primaria de Madrid. Se analizaron datos crudos, comparaciones entre grupos y análisis multivariante. RESULTADOS: En el análisis multivariante, las variables relacionadas con no comprar medicamentos prescritos son: tener menor nivel de ingresos OR=0,118 p < 0,0001 y de estudios OR=0,464, p = 0,001; con la disminución del gasto en alimentación: tener menos ingresos OR=0,100, p < 0,0001 y el número de miembros de la familia OR=1,308, p = 0,045; con vacunarse frente a rotavirus sin financiación influye el tener mayor nivel de ingresos OR=2,170, p = 0,0001 y de estudios OR=1,835, p = 0,013 y no ser inmigrante OR=0,532, p = 0,037. La presencia de problemas de salud desde la crisis está relacionada con encontrarse en paro OR=4,079, p = 0,032 y tener menor nivel de estudios R=0,678, p = 0,042 y de ingresos OR=0,342, p < 0,0001. En todos los casos los modelos presentaron una significación estadística para p < 0,0001. CONCLUSIONES: La crisis tiene mayor impacto en el grupo con menor nivel de ingresos en todas las variables analizadas. Influye el tener menor nivel de estudios y el número de miembros de la familia en la disminución de gasto en alimentación, el ser inmigrante en la no vacunación por rotavirus y el estar en paro en la presencia de problemas de salud en la familia. En resumen la crisis ha aumentado las desigualdades de acuerdo con el nivel socioeconómico

OBJECTIVE: To study the impact of the economic crisis on the families of the children who attend Primary Health Care and its relationship with their socioeconomic status. PATIENTS AND METHODS: Observational descriptive study was conducted by analysing the results of 453 questionnaires, given to the parents of children between 1 and 7 years old who attended 4 paediatric clinics in Madrid. The raw data was analysed, and comparisons between groups and multivariate analysis were performed. RESULTS: In the multivariate analysis, the variables related to the non-acquisition of prescribed medication are: lower income level OR=0.118, p<.0001 and lower educational level OR=0.464, p<.001; the variables related to the reduction of food expenditure are: lower income level OR=0.100, p<.0001 and a higher number of family members OR=1.308, p=.045; the variables related to anti-pneumococcal vaccination without public funding are: higher income level OR=2.170, p=.0001, higher educational level OR=1.835, p=.013, and not being an immigrant OR=0.532, p=.037. The presence of health problems from the beginning of the economic crisis is related to unemployment OR=4.079, p=.032, lower educational level R=0.678, p=.042, and income level OR=0.342, p<.0001. In all cases, the models achieved a statistical significance of p<.0001. CONCLUSIONS: The economic crisis has greater impact on the group with the lowest income level in all analysed variables. The lower educational level and higher number of family members has an impact on the reduction in food expenditure. The fact of being an immigrant has an impact on not receiving the anti-pneumococcal and rotavirus vaccination. Unemployment leads to an increase in health problems in the family. To sum up, the economic crisis has increased inequalities according to socioeconomic status

[Families of the economic crisis in paediatric Primary Care clinics: descriptive observational study]. / Las familias de la crisis en las consultas pediátricas de Atención Primaria: estudio descriptivo observacional.

OBJECTIVE: To study the impact of the economic crisis on the families of the children who attend Primary Health Care and its relationship with their socioeconomic status. PATIENTS AND METHODS: Observational descriptive study was conducted by analysing the results of 453 questionnaires, given to the parents of children between 1 and 7 years old who attended 4 paediatric clinics in Madrid. The raw data was analysed, and comparisons between groups and multivariate analysis were performed. RESULTS: In the multivariate analysis, the variables related to the non-acquisition of prescribed medication are: lower income level OR=0.118, p<.0001 and lower educational level OR=0.464, p<.001; the variables related to the reduction of food expenditure are: lower income level OR=0.100, p<.0001 and a higher number of family members OR=1.308, p=.045; the variables related to anti-pneumococcal vaccination without public funding are: higher income level OR=2.170, p=.0001, higher educational level OR=1.835, p=.013, and not being an immigrant OR=0.532, p=.037. The presence of health problems from the beginning of the economic crisis is related to unemployment OR=4.079, p=.032, lower educational level R=0.678, p=.042, and income level OR=0.342, p<.0001. In all cases, the models achieved a statistical significance of p<.0001. CONCLUSIONS: The economic crisis has greater impact on the group with the lowest income level in all analysed variables. The lower educational level and higher number of family members has an impact on the reduction in food expenditure. The fact of being an immigrant has an impact on not receiving the anti-pneumococcal and rotavirus vaccination. Unemployment leads to an increase in health problems in the family. To sum up, the economic crisis has increased inequalities according to socioeconomic status.

[Socioeconomic status and resource consumption in primary care]. / Nivel socioeconómico y consumo de recursos sanitarios en atención primaria.

OBJECTIVE: To determine the influence of socioeconomic status on healthcare demand and resource consumption in our population. PATIENTS AND METHODS: We performed a cross sectional, retrospective study of socioeconomic status and healthcare and pharmaceutical consumption in randomly selected patients from five primary care pediatric clinics in Madrid. The chi-square test was used to compare percentages. For the remaining analyses, nonparametric tests were used after confirming that the data followed non-normal distribution. RESULTS: We compared 684 questionnaires. Patients in the most disadvantaged socioeconomic levels consumed a greater number of drugs than those in more privileged levels (mean 0.79 vs. 0.47, p = 0.04). The mean pharmacological expenditure was also higher in the lowest socioeconomic levels than in the highest levels (5.28 Euros vs. 2.21 Euros, respectively; p = 0.001). No significant differences were found among socioeconomic levels in the number of consultations or diagnostic tests requested. The number of consultations was higher in younger patients (p < 0.001) or in those with chronic diseases (p = 0.001). Drug consumption was increased in the most disadvantaged levels (p = 0.002) and in patients with chronic diseases (p < 0.001). Lastly, pharmacological expenditure expressed in Euros was also higher in the lowest socioeconomic levels (p = 0.001) and in patients with chronic diseases (p < 0.001) but was lower if one of the parents was a foreigner (p = 0.031). CONCLUSIONS: We found a relationship between socioeconomic level and drug consumption and its attributable cost. These data should be confirmed by broader studies.

Nivel socioeconómico y consumo de recursos sanitarios en atención primaria / Socioeconomic status and resource consumption in primary care

Objetivo: Conocer la influencia del nivel socioeconómico en la demanda y consumo de recursos sanitarios de nuestra población. Pacientes y métodos: Estudio retrospectivo transversal, mediante cuestionario estructurado, del nivel socioeconómico y el consumo de recursos sanitarios y farmacéuticos en pacientes seleccionados aleatoriamente en cinco consultas de pediatría de atención primaria de Madrid. Se utilizó la prueba de la chi cuadrado (X2) para la comparación de porcentajes. Para el resto de los análisis se emplearon pruebas no paramétricas tras comprobarse la distribución anormal de los datos. Resultados: Se analizaron 684 cuestionarios. Los pacientes pertenecientes a los niveles socioeconómicos más desfavorecidos consumieron mayor número de fármacos que los de los niveles privilegiados (media, 0,79 frente a 0,47; p=0,04) y el gasto farmacéutico atribuido también fue mayor: en el nivel socioeconómico bajo el gasto medio fue de 5,28 y en el superior de 2,21 € (p=0,001). No hubo diferencias significativas entre los niveles socioeconómicos en lo que respecta al número de consultas o pruebas diagnósticas solicitadas. El número de consultas fue mayor en los pacientes de menor edad (p < 0,001) o en los que padecían alguna enfermedad crónica (p=0,001). El número de fármacos consumido se incrementó en los niveles más desfavorecidos (p=0,002) y en los pacientes con enfermedades crónicas (p < 0,001). Por último, el gasto farmacéutico expresado en euros también fue superior en los niveles socioeconómicos bajos (p=0,001) y en los pacientes con enfermedad crónica (p < 0,001), pero fue inferior si alguno de los progenitores era extranjero (p=0,031). Conclusiones: En nuestro estudio se ha encontrado una relación entre el nivel socioeconómico y el consumo de fármacos y su coste atribuido. Son necesarios estudios más amplios para confirmar estos datos (AU)