Ortega Tallón M A, Roca Figueres G, Iglesias Rodríguez M, Jurado Serrano J M
Especialista en Medicina Familiar y Comunitaria, Centro de Atención Primaria Terrassa Nord, Unidad Docente de Medicina de Familia y Comunitaria, Consorcio Sanitario de Terrassa. Barcelona, España.
Aten Primaria. 2004 Feb 15;33(2):78-85. doi: 10.1016/s0212-6567(04)79355-5.
To find the social and clinical characteristics of patients over-using (OUP) our centre. To find how much these patients use the health services.
Observational, descriptive study.
Urban primary care centre (36 408 inhabitants).
Patients over 15 seen at the centre during the year 2000, who exceeded in their number of attendances the mean plus two standard deviations for their age group.
The records of OUPS were reviewed to analyse their social and demographic characteristics, kinds of attendance, reasons for consultation, further tests, medication, referrals, and time off work this year.
The sample was of 954 OUPs, 50.9% of whom were male with an average age of 50.54 (SD, 19.68). 86.3% had some risk factor recorded (34% hypertension, 32.4% mental health, 27.7% obesity, 25.7% tobacco dependency, 17.7% diabetes mellitus). They generated a mean of 9.6 visits to the doctor per year, with 95% CI (8.09-11.19), with the most common reason for attendance the monitoring of acute pathology (19.29%), followed by monitoring of chronic pathology (14.32%). There was an average of 1 analysis per OUP per year, and 0.68 image tests per OUP per year (48.38% were simple x-rays). 46.8% of the medication prescribed were analgesics. Average time off work was 0.5 periods off per OUP per year, with a mean period of 49.4 days off (SD, 113.69). They engendered an average of 4.15 nursing visits per OUP per year, 95% CI (2.60-5.70), with monitoring of chronic pathology the most common reason for consultation. 30.3% of OUP had a visit to hospital casualty recorded, with osteo-muscular pathology the most common reason for consultation (34.29%). Mean referrals were 0.88 OUP per year, with traumatology being the department to which most referrals were made (13.92%).
OUP are middle-aged, have associated chronic pathology and use programmed appointments a lot. The additional tests conducted matched the centre's procedures for monitoring chronic pathologies. The most common reason for attendance at casualty was traumatology, as was the specialist clinic to which most referrals were made.
了解过度使用本中心服务的患者的社会和临床特征。了解这些患者使用医疗服务的程度。
观察性描述性研究。
城市初级保健中心（36408名居民）。
2000年在该中心就诊的15岁以上患者，其就诊次数超过其年龄组平均次数加两个标准差。
回顾过度使用服务患者的记录，分析其社会和人口统计学特征、就诊类型、咨询原因、进一步检查、用药、转诊及今年的误工情况。
样本包括954名过度使用服务的患者，其中50.9%为男性，平均年龄50.54岁（标准差19.68）。86.3%记录有某种风险因素（34%为高血压，32.4%为心理健康问题，27.7%为肥胖，25.7%为烟草依赖，17.7%为糖尿病）。他们每年平均看医生9.6次，95%置信区间为（8.09 - 11.19），最常见的就诊原因是急性病症监测（19.29%），其次是慢性病症监测（14.32%）。每位过度使用服务的患者每年平均进行1次分析检查，每年0.68次影像检查（48.38%为普通X光检查）。所开药物中46.8%为镇痛药。每位过度使用服务的患者每年平均误工0.5次，平均误工天数为49.4天（标准差113.69）。每位过度使用服务的患者每年平均接受4.15次护理访视，95%置信区间为（2.60 - 5.70），最常见的咨询原因是慢性病症监测。30.3%的过度使用服务患者有急诊就诊记录，最常见的咨询原因是肌肉骨骼病症（34.29%）。每年平均转诊0.88次，转诊最多的科室是创伤科（13.92%）。
过度使用服务的患者为中年人，伴有慢性病症，且经常使用预约服务。所进行的额外检查符合中心对慢性病症监测的程序。急诊就诊最常见的原因是创伤科，转诊最多的专科门诊也是创伤科。
