ABSTRACT
Objetivo. Analizar las ventajas de un modelo organizativo en atención primaria basado en mayor autonomía de gestión de profesionales respecto al modelo habitual (equipo dirigido por director médico). Mejorar la calidad asistencial y la satisfacción de pacientes y profesionales. Material y métodos. En febrero de 2009 un grupo de 6 médicos de familia y 4 administrativos se organizaron autónomamente para atender a 10.281 usuarios de 32.318 asignados al Centro de Atención Primaria (CAP) Les Corts de Barcelona. Entre marzo y diciembre de 2010 se incorporaron 7 enfermeras, 3 médicos y 2 administrativos más, atendiendo a 16.368 usuarios de 34.423 del centro. El modelo ha priorizado la autogestión de la demanda, autocobertura de profesionales, desburocratización de la consulta, mayor eficiencia y participación en investigación y docencia. Resultados. Resultados asistenciales: 1) Etapa piloto (diciembre/2008 a diciembre/2009): incremento de población atendida, disminución de visitas presenciales, importante aumento de atención no presencial, reducción muy significativa de demora de visita; reducción destacable de productos intermedios; menor utilización de novedades terapéuticas y mayor de medicamentos genéricos. 2) Etapa de consolidación (a diciembre de 2010, respecto a resto de profesionales del CAP): menos visitas presenciales y porcentaje muy superior de no presenciales atendiendo a más población asignada; menor gasto en productos intermedios. Otros resultados: mejora de la satisfacción profesional (cuestionario QVP-35) y participación activa en docencia e investigación. Conclusiones. El modelo ha innovado, mejorando la atención al usuario, dotando la consulta de mayor profesionalidad y aumentando la satisfacción de profesionales. Ha demostrado mayor eficiencia y los resultados obtenidos muestran superioridad al modelo habitual en indicadores de salud (AU)
Objective. To analyse the benefits of a new organisational model in Primary Care based on the empowerment of professional management compared to standard model (team led by medical director). To improve the quality of care, and patient and professional satisfaction. Material and methods. In February 2009 six family physician (FP) and four administrative staff met to create a self-management group to care for the 10,281 population assigned to them. The total catchment population of the Primary Care (PC) centre was 32,318. Additionally, between March and December 2010 three FP, seven nurses and two administrative staff, were included in the self-management group making the total population served by the self-management group of 16,368, compared to 15,950 patients seen using the standard model. The model gave priority to self-demand management, professional self-coverage, to reduce clinic bureaucracy, greater efficiency and participation in research and teaching. Results. 1) Milestone in Pilot Phase (December-2008 to December-2009): increase in attended population, reduction in clinic visits, significant reduction in delay to be visited by a doctor; significant reduction of complementary tests (x-rays, laboratory tests); increase in use of generic drugs and reduction of expensive and new drugs without added value, and active participation in teaching and clinical trials. 2) Consolidation Phase (December-2010, compared to other professionals working in a standard model in the same centre): self-management group reported a lower percentage of clinic visits and a higher percentage of visits resolved through telephoning the clinic. Furthermore, the self-management group achieved better financial results than the control group (additional medical tests, pharmacy budget). The self-management group had improved job satisfaction compared to control group (measured by Professional Questionnaire QoL-35). Conclusions. The new model has increased professional satisfaction and may improve results in some health indicators (accessibility, efficiency, pharmacy budget) compared with the usual clinical practice (AU)
Subject(s)
Humans , Male , Female , Primary Health Care/methods , Primary Health Care/trends , Delivery of Health Care/standards , Delivery of Health Care , Primary Health Care/standards , Primary Health Care , Delivery of Health Care/methods , Delivery of Health Care/trendsABSTRACT
OBJECTIVE: To analyse the benefits of a new organisational model in Primary Care based on the empowerment of professional management compared to standard model (team led by medical director). To improve the quality of care, and patient and professional satisfaction. MATERIAL AND METHODS: In February 2009 six family physician (FP) and four administrative staff met to create a self-management group to care for the 10,281 population assigned to them. The total catchment population of the Primary Care (PC) centre was 32,318. Additionally, between March and December 2010 three FP, seven nurses and two administrative staff, were included in the self-management group making the total population served by the self-management group of 16,368, compared to 15,950 patients seen using the standard model. The model gave priority to self-demand management, professional self-coverage, to reduce clinic bureaucracy, greater efficiency and participation in research and teaching. RESULTS: 1) Milestone in Pilot Phase (December-2008 to December-2009): increase in attended population, reduction in clinic visits, significant reduction in delay to be visited by a doctor; significant reduction of complementary tests (x-rays, laboratory tests); increase in use of generic drugs and reduction of expensive and new drugs without added value, and active participation in teaching and clinical trials. 2) Consolidation Phase (December-2010, compared to other professionals working in a standard model in the same centre): self-management group reported a lower percentage of clinic visits and a higher percentage of visits resolved through telephoning the clinic. Furthermore, the self-management group achieved better financial results than the control group (additional medical tests, pharmacy budget). The self-management group had improved job satisfaction compared to control group (measured by Professional Questionnaire QoL-35). CONCLUSIONS: The new model has increased professional satisfaction and may improve results in some health indicators (accessibility, efficiency, pharmacy budget) compared with the usual clinical practice.
Subject(s)
Models, Organizational , Primary Health Care/organization & administration , Quality of Health Care , Self Care/methods , Humans , Job Satisfaction , Patient Satisfaction , Pilot Projects , Primary Health Care/standards , Quality Indicators, Health CareABSTRACT
No disponible
No disponible
