Ortiz F, Quiles J, Menéndez D, Peris F
Dirección para la Gestión de Atención Primaria, Servei Valencià de Salut, Valencia.
Aten Primaria. 1996 Jun 15;18(1):9-16.
To improve the understanding of attendance pressure, its evolution over time and its relationship with the indicators of demand, use and age of the resources.
Descriptive and retrospective.
Primary care centres with an appointment system in the Community of Valencia. There were 6,756 valid registers of the monthly attendance pressure (1989-1993) available.
Attendance pressure has an extremely dispersed distribution. Behaviour which is constant in its evolution over time does exist, which allows a characteristic curve, repeated every year, to be defined: descent in August, two peaks in October and January and a third "mobile" peak around March and April. Mathematical equality between attendance pressure and the product of three factors has been obtained: duration of use per procedure x intensity of repeated use per procedure x ratio equivalent day. The analysis of the monthly evolution of each one of these three "components" helps understand changes in pressure. These "components" are also modified by the type and age of centre.
The wide dispersion of the results of technical productivity (attendance pressure), and the evidence of its change in composition over time and according to the care model offer important scope for management. It also creates the need for an explanatory model which includes the variables which determine both the attendance pressure and a method for altering it.
提高对就诊压力、其随时间的演变及其与资源需求、使用指标和资源年限之间关系的理解。
描述性和回顾性研究。
巴伦西亚自治区设有预约系统的初级保健中心。有6756份月度就诊压力的有效记录（1989 - 1993年）可供使用。
就诊压力分布极为分散。确实存在随时间演变保持不变的行为模式，据此可定义一条每年重复出现的特征曲线：8月下降，10月和1月出现两个峰值，3月和4月左右出现第三个“移动”峰值。已得出就诊压力与三个因素的乘积之间的数学等式：每个诊疗程序的使用时长×每个诊疗程序的重复使用强度×等效日比率。对这三个“组成部分”各自月度演变的分析有助于理解压力变化。这些“组成部分”也会因中心类型和年限而有所改变。
技术生产率（就诊压力）结果的广泛分散，以及其构成随时间和护理模式变化的证据，为管理提供了重要空间。这也促使需要一个解释模型，该模型应包含决定就诊压力的变量以及改变压力的方法。
