[A proposal for capitation payment, based on age, chronicity, and gender, using management databases].

OBJECTIVES

To propose a case-mix methodology for primary care, based on chronicity, type and age. To describe the explanatory value of these variables in the variability of the medical case-load.

DESIGN

Observation, descriptive and retrospective study.

SETTING

Primary care. Rochapea Health Centre, Pamplona.

MATERIAL AND METHODS

Computer records of all the consultations between January 1996 and June 1997. Dependent variable: case-load.

INDEPENDENT VARIABLES

age, type, chronic pathologies (diabetes, lipaemia, chronic neurological diseases, COPD-asthma, chronic psychiatric illnesses, cardiopathy, hypertension, alcohol and other drug abuse). The Kruskal-Wallis test was used to compare work-loads by age groups; and multiple linear regression analysis to calculate the predictive power of the independent variables.

RESULTS

Significant differences were observed for age groups. In the multivariate model used for general practitioners, all the variables could be included. They explained 24.2% of the variability in work load (R2). For paediatricians, age and asthma, explaining 23.48%, could also be included.

CONCLUSIONS

Age, type and chronicity are useful variables for predicting case load from administrative data bases. They can be used in adjustments for case load applicable to capitation payment systems.