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[某健康领域观察到的发病率:对专业人员和资金的影响]

[Morbidity observed in a health area: Impact on professionals and funding].

作者信息

de Miguel Pablo, Caballero Isabel, Rivas Francisco Javier, Manera Jaime, de Vicente María Auxiliadora, Gómez Ángel

机构信息

Área de Control de Gestión, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España.

Área de Control de Gestión, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España.

出版信息

Aten Primaria. 2015 May;47(5):301-7. doi: 10.1016/j.aprim.2014.07.008. Epub 2014 Oct 23.

Abstract

OBJECTIVE

To analyze morbidity, in the context of a health area, and broken down by health centre, of patients who made contact with healthcare services, in order to propose an adjustment to finance the payment per capita.

DESIGN

A descriptive study of morbidity observed in citizens assigned a health area during year 2010. SITE: Health Area 9. Autonomous Community of Madrid. Formed by the municipalities of Fuenlabrada, Humanes, and Moraleja de Enmedio. All levels of health care included.

PARTICIPANTS

All citizens with health card assigned to a health center in the area who has maintained contact with the public health service's own area.

MEASUREMENTS

Coded contact of patients are grouped using the Population Grouping Clinical Risk 3M TM Software (CRG). Each patient is included in a homogeneous and exclusive group with a numerical morbidity and clinical sense. Through the health card is known primary care centre, physician, age and sex.

RESULTS

The distribution of morbidity is obtained by primary care centre, primary care physician, age and sex analyzing differences and combinations.

CONCLUSIONS

It was found that the average values of the population morbidity are different in each primary care centre. In order to maintain the principle of equity in health care, it is suggested that an adjustment is made to the per capita payment based on the morbidity rate of the population.

摘要

目的

在一个卫生区域内,按卫生中心细分分析与医疗服务有接触的患者的发病率,以便提出人均支付费用的调整建议。

设计

对2010年分配到一个卫生区域的公民中观察到的发病率进行描述性研究。

地点

马德里自治区第9卫生区域。由富恩拉夫拉达、乌马内斯和恩梅迪奥的莫拉莱哈等市镇组成。涵盖所有医疗保健级别。

参与者

所有持有分配到该区域某一卫生中心的健康卡且与公共卫生服务本区域保持接触的公民。

测量

使用3M人口分组临床风险软件(CRG)对患者编码后的接触情况进行分组。每个患者被纳入一个具有数值发病率和临床意义的同质且排他的组。通过健康卡可知基层医疗中心、医生、年龄和性别。

结果

通过基层医疗中心、基层医疗医生、年龄和性别分析差异及组合情况,得出发病率分布。

结论

发现各基层医疗中心的人群发病率平均值不同。为维持医疗保健公平原则,建议根据人群发病率对人均支付费用进行调整。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/645b/6985634/ca48a6ff9420/gr1.jpg

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