Moreno Nemesio, Pera Guillem, Medina Manolo, Morral Rosa, Pareja Clara
Direcció d'Atenció Primària Metropolitana Nord. Institut Català de la Salut, Barcelona, España.
Unitat de Suport a la Recerca Metropolitana Nord, Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, España.
Aten Primaria. 2021 Jan;53(1):67-72. doi: 10.1016/j.aprim.2020.06.015. Epub 2020 Nov 7.
To determine which variables determine the average annual attendance time per patient in Primary Care (PC) in Catalonia to improve the adequacy of the budget allocation.
Cross-sectional ecological study.
The Primary Care health centers (EAP) from the Institut Català de la Salut (ICS) in 2016.
The 285 EAPs from the ICS, which cover 75% of citizens over 14 years of age in Catalonia.
Annual average time of visits by a family doctor per patient for each EAP. It was studied how this time depended on potential explanatory variables, at the EAP level, using linear regression models.
the average visit time per patient/year was 49 minutes, varying between 23-87 minutes according to EAP. The EAPs with older population, more comorbidity, more home care, worse socioeconomic index, greater number of young pensioners and greater dispersion had more visiting time, while the EAPs with more population and more women expended less time to visit. These variables explained 64% of the visit time variability.
The budget allocation in PC can be based on a model that incorporates the main determinants of patient' frequentation and adapts to their real needs. It would be necessary to deepen those factors that depend on the professional or health organizations to finish finding an optimal model of resource allocation in the PC.
确定哪些变量决定了加泰罗尼亚初级保健（PC）中每位患者的年平均就诊时间，以提高预算分配的合理性。
横断面生态学研究。
2016年加泰罗尼亚卫生研究所（ICS）的初级保健健康中心（EAP）。
ICS的285个EAP，覆盖加泰罗尼亚75%的14岁以上公民。
每个EAP中家庭医生为每位患者的年平均就诊时间。使用线性回归模型在EAP层面研究了该时间如何依赖于潜在的解释变量。
每位患者每年的平均就诊时间为49分钟，根据EAP的不同，在23 - 87分钟之间变化。人口老龄化、合并症更多、家庭护理更多、社会经济指数更差、年轻养老金领取者数量更多以及分布更分散的EAP就诊时间更长，而人口更多和女性更多的EAP就诊时间更短。这些变量解释了就诊时间变异性的64%。
初级保健中的预算分配可以基于一个纳入患者就诊主要决定因素并适应其实际需求的模型。有必要深入研究那些依赖专业人员或卫生组织的因素，以最终找到初级保健资源分配的最佳模型。
