Lomeña Villalobos J A, Ceballos Vacas M, Medina Arteaga M T, Mediavilla Cordero E, Sarmiento Jiménez F, Hernández Grande J L
Unidad Docente de Medicina Familiar y Comunitaria, Centro de Salud de Torre del Mar, Málaga.
Aten Primaria. 1996 Jun 15;18(1):35-8.
To find the origin of primary care pharmaceutical prescription and where expenditure is attributed.
A descriptive study of a prospective character.
Medical clinics of a primary care team at the Torre del Mar Health Centre, Málaga.
A total of 2,580 prescriptions, whose average price was 1,415.4 pesetas, with a range from 135 to 35,889 pesetas, were issued. An average of 143.3 prescriptions a day were issued during the days analysed. The number of prescriptions issued by PC itself made up more than half the prescriptions, similar to the number of prescriptions originating elsewhere. The average price is greater for outside prescriptions than for prescriptions from within PC. Total accumulated cost was 3,651,912 pesetas. Expenditure on outside prescriptions was 1,774,783 pesetas, 48.59% of total cost. Total cost of prescriptions from within PC was 1,733,701 pesetas, 47.47% of the total.
PC has been assigned the role of issuing most prescriptions in the health-care system. This causes various problems within PHC: 1) a major administrative overload; 2) a great imaginative effort to try to avoid bureaucratic burdens; and 3) a real ability to rationalise the offer of medicines using quality criteria of only about 50%, as the other 50% of medicines originates outside PHC. We believe an extension of the programmes to guarantee quality in specialist care is needed, particularly of those programmes relating to pharmaceutical prescription.
探寻初级保健药物处方的来源以及支出归属何处。
一项前瞻性描述性研究。
马拉加省托雷德尔马尔健康中心初级保健团队的医疗诊所。
共开出2580张处方，平均价格为1415.4比塞塔，价格范围从135比塞塔至35889比塞塔。在所分析的日子里，平均每天开出143.3张处方。初级保健本身开出的处方数量占处方总数的一半以上，与来自其他地方的处方数量相近。外部处方的平均价格高于初级保健内部处方的平均价格。累计总成本为3651912比塞塔。外部处方支出为1774783比塞塔，占总成本的48.59%。初级保健内部处方的总成本为1733701比塞塔，占总数的47.47%。
在医疗保健系统中，初级保健被赋予了开出大多数处方的职责。这在初级卫生保健中引发了各种问题：1）行政负担过重；2）为避免官僚负担需付出巨大的想象力；3）在运用质量标准合理提供药品方面，实际能力仅约为50%，因为另外50%的药品来自初级卫生保健之外。我们认为需要扩大保障专科护理质量的项目，特别是与药物处方相关的项目。
