Seguí Díaz M, Bartolozzi Castilla E, Ramos Aleixades J, Llach Fernández A, Torrent Quetglas M, Besco Villegas E, Pérez Martos M
UBS Es Castell, Centro de Salud de Dalt Sant Joan, Mahón, Menorca.
Aten Primaria. 1998 Sep 15;22(4):227-32.
A descriptive, crossover, prospective study based on all the prescriptions of the month of March (21 days) to 4156 patients from the town of Es Castell (5720 inhabitants), Menorca.
The variables to be evaluated were defined and classified in scales. They included prescription, packages, working age/pensioner, origin (General Practitioner, Specialist, Private, Emergency), cost of the prescription, specialties broken down into anatomical-therapeutic groups, whether it was chronic or acute medication, and whether it was of high or low therapeutic value.
Of the 3599 packages prescribed, 1993 were generated from outside the PC practice (55.3%). Of the 6069411 pesetas of expenditure in the period studied, 38.5% was due to general practitioners, 59.1% specialists, and 2.3% emergency services. 12.7% (456) of the packages prescribed were of low therapeutic value, of which 52.6% corresponded to the general practitioners' prescriptions, 45.6% to the specialists' and 4.5% to private practice. However, of the 523224 pesetas of expenditure, 62% was for specialists' prescriptions and only 36% for the general practitioners'. On comparing the profiles of prescriptions of low therapeutic value coming from specialists and direct from Primary Care, differences were found. The "cardiovascular" group accounted for 40.9% of specialist prescriptions and only 11.3% of G.P. ones; "central nervous system" (psychiatry, neurology) accounted for 24.5% and 12.1%, respectively. "Respiratory", however, was the opposite: 3.8% specialist and 25% G.P. Similarly the "others" category and 18.8% for specialists against 37.1% for G.P.s.
It can be inferred that there is shared responsibility in the public health system between specialists and G.P.s for prescribing products of low therapeutic value. However, since the medication that specialists prescribe is dearer, they cause more expenditure than the packages of low therapeutic value, which they delegate to G.P.s.
一项描述性、交叉、前瞻性研究，基于梅诺卡岛埃斯 Castell 镇（5720 名居民）4156 名患者 3 月（21 天）的所有处方。
对要评估的变量进行定义并按量表分类。包括处方、包装、工作年龄/退休人员、来源（全科医生、专科医生、私人、急诊）、处方费用、按解剖治疗组细分的专科、是慢性还是急性药物以及是高治疗价值还是低治疗价值。
在开具的 3599 份包装中，1993 份来自初级保健机构之外（55.3%）。在所研究期间的 6069411 比塞塔支出中，38.5% 归因于全科医生，59.1% 归因于专科医生，2.3% 归因于急诊服务。开具的包装中有 12.7%（456 份）为低治疗价值，其中 52.6% 对应全科医生的处方，45.6% 对应专科医生的处方，4.5% 对应私人执业处方。然而，在 523224 比塞塔的支出中，62% 用于专科医生的处方，仅 36% 用于全科医生的处方。比较专科医生直接开具的低治疗价值处方和初级保健直接开具的低治疗价值处方的特征，发现了差异。“心血管”组占专科医生处方的 40.9%，仅占全科医生处方的 11.3%；“中枢神经系统”（精神病学、神经病学）分别占 24.5% 和 12.1%。然而，“呼吸系统”则相反：专科医生为 3.8%，全科医生为 25%。同样，“其他”类别专科医生为 18.8%，全科医生为 37.1%。
可以推断，在公共卫生系统中，专科医生和全科医生在开具低治疗价值产品方面存在共同责任。然而，由于专科医生开具的药物更昂贵，他们导致的支出比他们委托给全科医生的低治疗价值包装更多。
