[The impact of primary health care reform in the utilization of medical and nursing services. Working Group on the Utilization of of Health Services].

OBJECTIVES

To describe the use of medical and nursing services and changes attributable to the Primary Care reform.

DESIGN

A crossover study based in the community.

SETTING

The city of Mataró (Barcelona), divided into seven Health Districts, four of which are reformed.

PATIENTS AND OTHER PARTICIPANTS

A representative sample of 1,880 beneficiaries of the public health service.

INTERVENTIONS

A home survey (February to June 1994).

MEASUREMENTS AND MAIN RESULTS

The annual rate of use of the doctor was 78.9% and the frequency of attendance was 7.74 visits per person per year. Both rates were higher among women and increased with age, the 0 to 14-year old group being exceptional. The rate of use was greater in the reformed Districts as against the non-reformed ones; with the difference in frequency of visits not reaching statistical significance. Reformed Health District users stated they made less administrative visits and more prevention or follow-up attendances. Nursing services were used in the 2 weeks before the interview by 6.3%.

CONCLUSIONS

In both Primary Care models, factors meaning greater demand on both doctors and nurses are advanced age and being female.