Reyes Rodríguez José Félix, González-Casanova González Sonia
Gerencia de Atención Primaria de Tenerife, Servicio Canario de Salud. Santa Cruz de Tenerife. España.
Rev Esp Salud Publica. 2024 Jul 17;98:e202407043.
COVID-19 has evidenced the importance of a Primary and Community Care (PCC), able to respond in the front line with capacity and adaptation to health and social crises. In order to reinforce its role, the Strategic Framework for Primary and Community Care was created in 2019, and one of its lines of action is to consolidate a budgetary and human resources policy. This translates into the Primary Care Action Plan 2022 and 2023, which includes the adequacy of HHRR based on the morbidity attended, health outcomes and sociodemographic characteristics. For this purpose, the development of the model for its calculation is urged. The objective of this paper was to offer a model as a guideline for the adequacy of the needs of Family Care Units (FAU).
The study was carried out in the Tenerife Health Area, which has 41 ZBS with 97 health care centers. The variables weighted in the model were: percentage of people over 65 years of age; utilization index; complexity by GMA (Adjusted Morbidity Groups) and frequentation. An Adequate Quota Index was calculated to establish the quota for each health care center between 1,200 and 1,600 per UAF and projection to 2025.
The total need for UAF increase was 62, compared to 57 with the capita criterion of 1,500, at the extremes of the model range there were 12 centers of 1,200 and 11 of 1,600.
In a very heterogeneous Health Area, the model achieves a more equitable allocation without increasing in practice the need for FAUs compared to the capitated criterion.
2019年创建了初级和社区护理战略框架,以加强其在应对健康和社会危机时的一线响应能力,这证明了初级和社区护理(PCC)的重要性。其行动方针之一是巩固预算和人力资源政策。这转化为《2022年和2023年初级护理行动计划》,其中包括根据所诊治的发病率、健康结果和社会人口特征调整人力和人力资源。为此,迫切需要开发其计算模型。本文的目的是提供一个模型,作为家庭护理单位(FAU)需求适配的指导方针。
该研究在特内里费健康区进行,该区有41个基本卫生服务区域(ZBS)和97个医疗中心。模型中加权的变量包括:65岁以上人群的百分比;利用指数;按调整后发病组(GMA)划分的复杂性和就诊频率。计算了一个充足配额指数,以确定每个医疗中心在每个家庭护理单位(UAF)1200至1600之间的配额,并预测到2025年。
与按人均1500的标准计算的57个相比,家庭护理单位(UAF)增加的总需求为62个,在模型范围的两端,有12个中心为1200个,11个中心为1600个。
在一个非常多样化的健康区,与按人头计算的标准相比,该模型实现了更公平的分配,而实际上并未增加对家庭护理单位(FAU)的需求。