[The factors that influence the use of antibiotics in primary care]. / Factores que influyen sobre la utilización de antibióticos en atención primaria.

OBJECTIVE: To identify factors influencing volume, quality and power of antibiotic prescription in primary care. DESIGN: Descriptive, crossover study. SETTING: Sanitary Region Coast of Ponent, 1992. PARTICIPANTS: They were studied 468 practitioners of primary care attention. 68 practitioners were excluded by various reasons. MEASUREMENTS AND MAIN RESULTS: The factors studied were: factors coming from the practitioner, the centre, and the assisted population. The following parameters were analysed: amount of prescribed antibiotics in DDDs, election level ("antibiotic power") and percentage of DDDs of low intrinsic value. It was used for the comparison of means, Student-Fisher t test and the confidence intervals of the difference. Also it was used the step-wise multiple regression analysis. Greater use of antibiotics. The variability can be explained through regression in a 45.7% in function of the doctors factors, not integrated in a team, older, doctor who works in a rural centre, of young population and of smaller revenue. Greater antibiotic power. It's explained in a 5.09% by the medical factors like man, that works in a not educational centre and of greater population revenue. Greater percentage of DDDs of low intrinsic value. It's greater in doctors not specialized in family care, permanent job, of greater age, men, not reformed professional and not of an educational centre. CONCLUSIONS: The volume of prescription of antibiotics and in minor extent its quality of prescription are in some part justified by variables coming from the practitioner, the centre and the assisted population. The antibiotic power mainly doesn't.

[Relationship between the physician's profile and transient work incapacity of his patients]. / Relación entre el perfil del médico de cabecera y la incapacidad laboral transitoria de sus pacientes.

OBJECTIVE: To discover the relation between doctor's profile and his patient's unfitness for work. DESIGN: This was an observational crossover study. SETTING: Regional health authorities of Sant Feliu (Barcelona). PARTICIPANTS: 30 general practitioners throughout the whole of 1992. MEASUREMENTS AND MAIN RESULTS: Temporary doctors concede significance less unfitness for work (p = 0.002), and less unfitness motivated by flu (p = 0.028) than the others. Doctors belonging to the morning shift concede more upper respiratory infectious process (p = 0.03) than doctors belonging to the afternoon shift. Younger doctors and those specialised in family practice concede less unfitness for work motivated by flu than the others (p = 0.020) and (p = 0.019) respectively. CONCLUSIONS: The doctor's stability of work is the most influential factor analysed of the unfitness for work of his patients.

[Determining factors of the quality of prescription measured in intrinsic value and its potential use]. / Factores condicionantes de la calidad de la prescripción, medida en valor intrínseco y grado potencial de uso.

OBJECTIVE: To determine whether the following factors-medical training in family practice, age of the doctor, health care organization and percentage of patients over 65 years--influence the quality of pharmaceutical prescription as measured in terms of its intrinsic value and potential use of the prescription. DESIGN: Descriptive cross study. SITE. Regional health authorities of Costa de Ponent. Barcelona. PARTICIPANTS: 400 general practitioners throughout the whole of 1992. MAIN MEASUREMENTS AND RESULTS: Doctors belonging to the new health system and specialising in family practise, present higher intrinsic value and potential use of the prescription (statistically confirmed), as well as a greater concentration of prescription of the top 100 prescribed medicines. Doctors no more than 40 years old had better prescription but no statistical differences were found. An aged population had nearly no influence. CONCLUSIONS: The characteristics of the doctor (organization, training) are conditioning factors in the quality of pharmaceutical prescription.